Volume 88  ·   Issue 33  ·  2008

Glioma has the characteristics of high morbidity, high recurrence rate and high mortality rate, which is one of the difficulties in neurosurgical treatment. The combination of surgery with radiotherapy and chemotherapy is a standardized treatment plan for glioma. With the continuous application of new technologies and methods, some progress has been made in the clinical treatment of glioma.

With the deepening of the understanding of the molecular mechanism of tumor and the advancement of molecular diagnostic technology, the clinical treatment methods for tumor are also changing. The advancement of the understanding of the molecular basis of disease, the search for disease biomarkers, especially the emergence of targeted therapy for specific molecular changes of cancer, herald the arrival of the era of molecular pathological diagnosis.

Objectives To investigate the possibility of transplantation of human glioma stem cells (HGSCs) in nude mice stably expressing green fluorescent protein (GFP) so as to clearly identify the incubated HGSCs from the host tissues. Methods Transgenic C57BL/6J mice expressing GFP was crossed with nude mice of the line NC, then hairless male nude mice expressing GFP were crossed with hairy female pubescent mice to obtain nude mice with GFP expression the expression of GFP in the skin and organs of these nude mice were evaluated by naked eyes, and immunohistochemical and immunofluorescence assays. HGSCs were transplanted orthotopically into the caudate nuclei of nude mice expressing GFP. Immunohistochemistry was used to observe the transplanted tumor. Results The structures rich in adipose tissue of the 8th generation nude mice were dark green and the other organs were light green. However, green fluorescence was emitted from all tissues under fluorescence microscopy. Confocal fluorescence microscopy showed that the tumor cells were stained red, distinguished from the host ceils distinctly in the brains bearing tumor transplanted orthotopically. Conclusion Nude mice expressing GFP can be obtained by crossing the trangenic mice bearing naive immunity with nude mice. Orthotopic transplantation of HGSCs may be used in the investigation of tumor tissue reconstitution because of the easy identification between the transplantation tumor and host tissue.

Objective To isolate cancer stem cells glioblastoma cells and detect the expression of anti-apoptotic and multi-drug resistance-associated protein (MRP) genes thereof. Methods CD133 positive ceils were isolated from human glioblastoma muhiforme cells of the line TJ905 by immunomagnetic beads technique and nestin, β-tubulin and GFAP expression were examined by Immunofluoresence staining. RT- PCR was used to detect the expression of livin, livinα, Livinβ, Survivin, MRP1, and MRP3. Results Only 0.21% of the TJ905 cells maintained in serum was CD133+ and showed characteristics of cancer stem ceils, positive in nestin. These cens maintained a sphere-like growth status in serum-free medium in vitro, and could self-renew, proliferate, conditionally differentiate into tubulin-β+ and GFAP+ cells, and produce neurons as well as glial cells. The mRNA expression levels of livin, livinα, survivin, MRP1, and MRP3 of the TJ905 tumor stem cells were significantly lower than those f the of TJ905 cells. Conclusion Cancer stem cells can be isolated from TJ905 glioblastoma muhiforme cells. However, the generating rate of the tumor stem cells is lower than that of the TJ905 cells, and the expression levels of anti-apoptotic and MRP genes are lower than those of the progenitor cells. Showing that cancer stem cells are not the solo factor to maintain tumor growth and resist apoptosis and to pump the anti-tumor drugs out of cells.

Objective To summarize the experience in cranial-orbital approach in the treatment of optic nerve glioma. Method The clinical data of 35 patients with optic nerve glioma diagnosed by CT and MRI, 26 males and 9 females; aged 13 ( 1 - 54), with the main clinical presentations of visual defection and ex-ophthalmos and with the courses from 1 to 36 months, who underwent operation via the cranial-orbital approach 36 times, were analyzed. The diagnosis was confirmed by pathology after operation in 35 cases. Follow-up was conducted for 3 months to 8 years. Results Total resection was achieved in 29 cases, and subtotal resection in 6 cases. The surgical complications included temporary cerebrospinal fluid rhinorrhea (2 cases) and cataract (1 cases), and no ocular movement dysfunction was found. The follow-up rate was 77.1% (27/35). Three cases suffered from recurrence, spinal metastasis was found in 1 case, and 1 case died. Conclusion resection of optic nerve glioma via cranial-orbital approach is effective. However, since residual tumor may remain in the optic nerve canal, post-operative radiation therapy is recommended.

Objective To investigate the features of acute dopaminergic responsiveness test in patients with Parkinsonian disorders, and to find a convenient approach of differential diagnosis of Parkinsonian disorders. Methods Sixty inpatients with Parkinson disease (PD) or Parkinson's syndrome, including vascular Parkinsonism (VP), multiple system atrophy (MSA), ete, were given the Levodopa and Benserazide tablets, containing levodopa of the doses of 62.5, 125 187.5,250, and 375 mg in a pattern of gradual acute DOPA test. The third part of the unified Parkinson's disease rating scale (UPDRS) was used to evaluate the development of PD symptom before and 1 hour after taking the medicine. The differences among the improvement rates were compared with one-way ANOVA test and post hoc multiple comparison by SSPS 11.5. Results The improvement rates after taking the Levodopa and Benserazide tablets were 11.3% for the dose of 62.5 mg, 23.1% for 125 mg, 29.4% for 187.5 mg, 31.2% for 250 mg, and 34.3% for 375 mg. When the dose was 65 nag there was no significant difference between the diagnoses of PD and Parkinsonism, however, when the doses were 125, 187.5,250, and 375 mg, and the improvement rates ≥ 23.1%, 29.4%, 31.2%, and 34.3% were used as the indicators of diagnosis of PD, there were significant differences between the diagnoses of PD and Parkinson's syndrome. Conclusion Easy and convenient, acute dopaminergic responsiveness test is not associated with sex, age, and H-Y ranking, and is an important approach in differential diagnosis of Parkinsonian disorders.

Objective To find valuable implantation-related genes associated with endometrial receptivity by scanning the complete genome array of endometrium at the luteal phase of superovulation cycle and the natural cycle. Methods Twenty endometrial samples were obtained from patients who were to undergo invitro fertilizat6ion and embryo transfer because of the ovarian or male factors, underwent real-time quantitative PCR (QPCR) to confirm the differentially expressed genes and pathological examination to confirm the stages. Five of the 20 endometrial samples from days of LH + 4, LH + 7, or HCG + 7 underwent HU133 plus2.0 microarray scanning. The other 15 samples were divided into 2 groups: 7 samples were taken on the day LH + 7, and 8 samples taken on the day HCG + 7. Results 581 genes were expressed differentially in the LH +7 and LH +4 samples: 395 were up-regulated and 186 were down-regulated. 320 genes were expressed differentially in the HCG + 7 and LH + 7 samples: 175 genes were up-regulated, and 145 genes were down- regulated. QPCR test showed that the expression levels of some up-regulated genes were much lower on the day HCG +7 than on the day LH +7, such as PAEP, SlooP, SOD and GDF15. Conclusion Microarray scanning provides a global gene expression spectrum of human endometrium at different phases. A set of genes are active at the implantation window phase of endometrium. These genes don't show adequate expression after superovulation, which may lead to the change of endometrial receptivity.

Objective To evaluate the effects of Yunnan Baiyao capsules on facial swelling and anti-inflammatory response after orthognathic surgery. Methods 87 patients scheduled for Le Fort I osteotomy and bilateral sagittal split ramus osteotomy (BSSRO) and genioplasty were randomly divided into 2 groups: experiment roup (n =43) given with Yunnan Baiyao capsules orally 4 days before operation once daily and then via nasal feeding tube after operation once a day for 5 days, and placebo group given with placebo capsules. Antibiotic was routinely given to both groups. Serum levels of C-reactive protein (CRP), interleukin 6 ( IL-6), and IL-1 were quantified on postoperative days 1,2,3, and 5. Degrees of facial swelling were evaluated on postoperative days 3,5, and 7. Results Peak CRP and cytokines levels were reached on the first postoperative day in both groups, and the the variables decreased. The serum concentrations of CRP and IL-6 in the Yunan Baiyao group were lower than those in the control group. The CRP kevels on the postoperative day 2, 3 and 5 of the experiment group were all significantly lower than those of the placebo group, and the IL-6 level on the second postoperative day of the experiment group was significantly lower than that of the placebo group. Conclusion Perioperative administration of Yunnan Baiyao capsules can reduce the magnitude of inflammatory response and facial swelling after orthognathie surgery. Yunnan Baiyao capsule has efficacy of anti-inflammatory response.

Objective To investigate the effect of thymopentin 5 (TP5) combined with immunosuppressive agents in treatment of relapse after extended thymectomy in patients with myasthenia gravis (MG). Methods One hundred thirty-five MG patients who were to undergo extended thymectomy, 62 adults and 73 children, were randomly assigned to 2 groups : non-TP5 group ( n = 60) treated with intramuscular injection of prednisone + pyridostiamine daily for 3 months as a basic treatment, and TP5 group ( n = 73), treated with prednisone + pyridostiamine + TP5 for 3 months. Follow-up was conducted for more than 1 year. Results The remission rates of children in the TP5 group at different time points were all markedly higher than those in the non-TP5 group, and the remission rates of children in the TP5 group during the period of 2 months to 2 years after thymeetomy were all significantly higher ( all P< 0.05 ). And the remission rates of the adults of the TP5 group during the period of 6 months to 2 years after thymectomy were all significantly higher than those of the non-TP5 group ( all P< 0.05 ). In the pediatric cases the withdrawal rate of the TP5 group was significantly higher, and the relapse rate was significantly lower than those of the non-TP5 group. No side effect developed during the follow-up. Conclusion TP5 is effective in reducing relapse and has a higher drug withdrawal rate, especially among children.

Objective To investigate the safety and effectiveness of 3 methods of central vein catheters indwelling in cancer patients undergoing chemotherapy. Methods 120 cancer patients undergoing long-term chemotherapy(9 months-2 years)were divided into 3 equal groups to be treated via peripherally inserted central catheter(PICC), untunneled central venous catheter (CVC) by repeat venipuncture (20 through jugular vein and 20 through subclavian vein), and implanted subinfuse-port ( PORT, 20 through jugular vein and 20 through subclavian vein). The complications of implantation and quality of life were compared. Results The early complication of the PICC group was malposition of the tip of catheters; and the early complications of the CVC group included hematoma in the jugular vein subgroup and pneumothorax in the subclavian vein subgroup. The incidence rates of catheter obstruction and thrombosis of the PORT group were significantly higher than those of the other two groups ( all P< 0.05 ). The incidence rate of infection (regional and systemic) of the PORT group was significantly lower than those of the other two groups (both P<0. 05). The satisfaction score during chemotherapy of the PORT group was (5.6±1.6), significantly higher than those of the PICC and CVC groups [ (3.3±0.8 ) and ( 3.9±0.6) respectively, both P< 0. 05 ], and the satisfaction score between chemotherapy courses of the PORT group was (5.7± 0.7), significantly higher than those of the PICC and CVC groups [ (4.5±0.8 ) and (4.8 ± 1.2 ) respectively, both P< 0.05 ]. Conchusion The technology of central vein catheter indwelling with subcutaneous port in patients undergoing chemotherapy is effective and safe.

Objective To detect the expression of phosphatase of regenerating liver (PRL)-3 in primary gastric cancer tissues, evaluate its prognostic impact, and investigate the role of silencing PRL-3 expression by miRNA interference in gastric cancer growth. Methods Immunohistochemistry was used to measure the expression of PRL-3 in 137 gastric tumor samples. The overall survival rates of the patients with different PRL-3 expression levels were compared. Recombinant lentivirus expressing artificial PRL-3 miRNA, Lent. rPRL3-miRs, was established. Human gastric cancer ceils of the line SGC7901 were cultured and transfected with Lent. rPRL3-miRs or blank vector, Lenti. rPRL-miR-neg, respectively. Un-transfected progenitor cells were used as controls. MTT assay was used to examine the proliferation of these cells. RTPCR and Western blotting were used to detect the RNA and protein expression of PRL-3 in the SGC7901 cells. Thirty BALB/c mice were divided into 3 equal groups to be inoculated subcutaneously with SGC7901 ceils transfected with Lent. rPRL3-miRs or blank vector, and control SGC7901 ceils respectively. The growth of tumor was observed and the tumor sizes were measured 21 days later. Results 85 of the 137 gastric cancer samples (62%) showed high PRL-3 expression and 26 (19%) showed moderate and low PRL-3 expression. High PRL-3 expression was significantly correlated with tumor size ( P< 0. 01 ), infiltration depth (P< 0. 01 ), lymph node metastasis ( P< 0. 01 ), hepatic metastasis ( P< 0. 01 ), adjacent organ invasion ( P< 0. 01 ), and TNM staging ( P< 0. 01 ). The median survival time of the patients with high PRL-3 expression in the primary tumor was 18.9 months, significantly shorter than those with moderate or low expression (39.1 and 74.3 months respectively, both P< 0. 01 ). The growth rate of the SGC7901 cells transfected with the recombinant lentivirus expressing artificial PRL-3 miRNA was significantly lower than that of the blank vector-transfected group. The implanted tumor size of the Lenti. rPRL-3-miR-B transfection group was ( 1.92 ±0. 18 ) cm3, significantly smaller than those of the control and Lenti. rPRL-miR-neg groups [(4.86±0.38) and(4.74±0.39)cm3 respectively, both P<0.01]. Conclusion High PRL-3 expression is associated with gastric cancer progression. Silencing of PRL-3 significantly suppresses the proliferation of gastric cancer cells and tumor growth. PRL-3 plays a key role in the growth of gastric cancer. PRL-3 should be considered as a potential therapeutic target.

Objective To provide pertinent anatomic data and details for the clinical application of the extended transsphenoidal approach; to probe the anatomic characteristic and method under endoscope; Methods 25 adult cadaver heads fixed in formalin were used to dessect, observe, measure and photograph the relationship between the neural and vascular structure and the important anatomic landmarks related to the extended transsphenoidal approach under endoscope. Results The posterior and lateral wall of sphenoidal sinus could be well exposed by bilateral approach under endoscope. The clinical application of endoscope could improve the illumination of the operative field, magnify the objects and provide twodimensional images. The distortion of the images under endoscope depended upon the distance between the lens and the object as well as the angle of the lens. To establish the anatomic vertical compartment under the endoscope might be helpful to the operation. The midline vertical compartment consisted of the planum sphenoidale, tuberculum sella, sella and clival indertation. The paramedian vertical compartment was composed of the medial third of the optic canal and the carotid artery protuberance. The lateral vertical compartment contained four bony protuberances (optic, cavernous sinus apex, maxillary, and mandibular). Endoscopic surgical maneuvering was under non-midline direction. Precise surgical landmarks are essential for a successful operation. These landmarks allowed the surgeon to recognize and approach the surgical target without confusion. The nasopharynx, middle turbinate, and inferior turbinate were some of the landmarks in the nasal cavity. Once the sphenoidal sinus was entered, the anatomic structures of the sphenoidal sinus posterior wall, which were described above, were the unique landmarks that will guide the surgeon to the surgical target. Conclusion The anatomic characteristics under endoscope were different from those under microscope. The application of the extended transsphenoidal approach under endoscope could provide more extensive vision and satisfied exposure to reach the area of the central skull base.

Objective To explore the existence of side-population cells (SP cells) in human decidual tissues in early pregnancy, and its biological characteristics. Methods Decidual cells were obtained by enzymatic digestion from the decidual tissues of human early pregnancy. The cells then were stained with Hoechst33342 dye either alone or in combination with verapamil. Fluorescence-activated cell sorter (FACS) analysis was used to identify and isolate SP cells. The isolated cells were cultured in conditioned media culture to observe the proliferation and ability to form colony. Results Stem cells were found in the decidual tissues of early pregnancy with a percentage of 0.78%± 0.71% (0% -3.20% ). These cells further proliferated and formed colonies during long-time culture in vitro. No significant statistical difference was found in contents of SP cells among different gestational week (P >0.05 ). Conclusion SP cells exist in human decidua that can further proliferate and have the clonogenicity in culture in vitro.

Objective To evaluate and compare the postoperative implant-related complications after treatment of intertrochanteric fracture by gamma nail or by sliding hip screw. Methods Literatures on randomized controlled trials (RCTs) of the postoperative implant-related complications after treatment of intertrochanteric fracture by gamma nail or by sliding hip screw published before the end of June 2007 were retrieved from Cochrane library, Medline, Embase databank, and Chinese Biomedical Database. Relevant articles were handsearched in several Chinese journals. Methodology quality of the trials was critically assessed and data on postoperative implant-related complications were extracted. The software RevMan4.2. 10 provided by the Cochrane Collaboration was used for meta-analysis. Results 10 RCTs and 3 quasi-RCTs involving 1857 cases were included. The results of meta-analysis showed that gamma nailing significantly increased the rate of postoperative femoral shaft fractures [ RR = 3.75, 95% CI ( 1.47, 9.55 ), P = 0.006 ]. However, there were no statistic differences in the rates of lag screw cut-out and total mechanical complications between gamma nail and sliding hip screw treatment. Conclusion Compared with sliding hip screw for intertrochanteric fractures, gamma nailing can lead to higher incidence of postoperative femoral shaft fractures. Fracture stability may influence the rate of postoperative implant-related complications. Further large sample and high quality RCTs based on fracture stability are required in order to provide more sufficient and reliable evidence.

Objective To explore the possibility to establish Sjogren's syndrome models by immunizing mice with α-fodrin. Methods Twenty-four 4-week-old BALB/C mice were randomly divided into 4 equal groups to undergo subcutaneous injection of α-Fodrin, submaxillary gland homogenate and glutathione S-transferase (GST) or phosphate-buffered saline (PBS) ( negative control groups) on days 0, 14, 35, and 56 respectively. The drinking amount of water was measured. Blood samples were collected every 2-3 weeks. Munofluorescence assays and ELISA were used to examine the presence of anti-Fodrin, anti-type 3 muscarinic acetylcholine receptor polypeptide (M3RP), anti-SSA, anti-SSB, rheumatoid factor (RF), and antinuclear antibody (ANA). Immunochemistry was used to detect the levels of interferon (IFN)-γ , interleukin (IL)-2, and IL-10. One mouse was killed from each group every 2-3 weeks. The salivary glands were examined. Results (1) No auto-immune antibody was found in the serum samples of the mice before immunization. Antibodies against α-Fodrin and M2RP, and ANA were positive in the serum samples of the α-Fodrin and submaxillary gland homogenate groups since the 35th day after immunization, and were all negative in the 2 control groups. However, no antibodies against SSA, SSB and RF were found in all 4 groups. (2) Lymphocytic infiltration could be seen in the salivary glands of the immunized animals since 50th days after the first immunization of α-Fodrin and submaxillary gland homogenate. Immunohistochemistry showed α-Fodrin expression in the submaxillary glands of the α-Fodfin and submaxillary gland homogenate groups, but not in the PBS and GST controls. (3) The serum IFN-α levels of the α-Fodrin and submaxillary gland homogenate groups were ( 81.6±7.1 ) and ( 90.5±4.9 ) pg/ml respectively, both significantly higher than those of the GST and PBS groups [ ( 30.1±5.9) and (19.3± 6.4) pg/ml respectively, both P< 0.05 ]. The serum IL-2 levels of the α-Fodrin and submaxillary gland homogenate groups were ( 18.7±2.3 ) and ( 19.8±0.9) pg/ml respectively, both significantly higher than those of the GST and PBS groups [ (4.9±1.1 ) and (3.5±1.6) pg/ml respectively, both P< 0.05]. No difference was found in the level of serum IL-10 among the 4 groups. (4) There was no significant difference in the volume of water volume drunk among the 4 groups. Conclusion (1) It is possible to establish mouse mice SS models by immunization with α-Fodrin or submaxillary gland homogenate that are reminiscent of human SS. (2) The appearance of multiple antibodies may be related to the antigen epitope spreading. (3) The pathogenesis of SS may be related to Thl type response.

Objective To test the hypothesis that spinal cord protection induced by ischemie postconditioning is mediated by an increase of endogenous antioxidant enzyme activities during reperfusion phase in spinal cord. Methods Seventy-eight male New Zealand rabbits were randomly divided into 3 groups : Sham group ( n = 18 ) undergoing sham operation without aortic occlusion ; ischemia/reperfusion ( I/ R) group (n = 30 ) undergoing occlusion of the infrarenal abdominal aorta for 20 min, followed by reperfusion ; and postconditioning (PostC) group (n = 30) undergoing occlusion of the infrarenal abdominal aorta for 20 min followed by 3 cycles of 30 s reperfusion/30 s ischemia just at the onset of reperfusion. 30 min, and 1,3, 6, 24, and 48 h after reperfusion 5 rabbits from each group (and 3 from the Sham group) were killed with their spinal cords taken out, and spectrophotometric method was used to determine the antioxidant enzyme activity and malondialdehyde (MDA) content 6, 24, and 48 h after reperfusion motor function scoring of the hind limbs was conducted. Results ① The motor function scores of the PostC group were significantly higher than those of the I/R group 6, 24, and 48 h after reperfusion ( all P< 0. 05 ). ② The activities of superoxide dismutase (SOD) and catalase (CAT) in the spinal cord tissue of the PostC group 30 min-6 h after reperfusion were all significantly higher than those of the I/R group( all P<0.05). There were no significant differences in the activity of glutathione peroxidase (GSH-px) at different time points between the PostC and I/R groups. ③ The MDA levels 24 h and 48 h after reperfusion of the PostC group were both significantly lower than that of the I/R group ( both P< O. O1 ). Conclusion Ischemic postconditioning shows effect against spinal cord ischemic-reperfusion injury mediated, at least partially, by up-regulating the activities of SOD and CAT in spinal cord during early reperfusion phase.

Objective To investigate the mechanism of rapid amelioration of the pathological changes in experimental allergic encephalomyelitis (EAE) by 1,25-dihydroxyvitamin D3 [ 1,25-(OH)2D3 ]. Methods Forty Lewis rats were immunized with myelin basic protein in complete Freud's adjuvant so as to establish ESE animal models and then randomly divided into 4 equal groups: prevention group, fed with 1, 25-(OH)2D3 since day O for 10 days, prevention-control group fed with peanut oil for 10 days, treatment group fed with 1, 25-( OH )2D3 since the appearance of EAE symptoms (generally since day 10 or 11 ), and treatment-control group fed with peanut oil since the appearance of EAE symptoms. The clinical symptoms were scored since immunization till day 12 when the clinical symptoms reached the maximum level. The rats were sacrificed 13 days after sensitization with their brains and spinal cords taken out to undergo pathological examination, in situ TUNEL staining for detecting apoptotic cells, and semiquantitative immunohistochemical analysis to detect the inducible NO synthase (iNOS), FasL, and tumor growth factor (TGF)-β1, that might involve in the signal pathway of apoptosis. Peripheral blood samples were collected to isolate mononuclear cells ( MNCs). The content of nitrite in the supernatant of MNC culture was evaluated. Results The scores of clinical symptoms and the pathological changes of both the prevention and treatment groups decreased conspicuously and were significantly lower than their respective control groups ( both P< 0.01 ). In contrast, the apoptosis indexes of the 2 1, 25-(OH)2D3 administration groups were significantly higher than those of the control groups (all P<0.01 ). The TUNEL positive cell rates in the brain and spinal cord of the treatment and prevention groups were all significantly higher than those of their corresponding control groups (P<0.05, P< 0.O1 ). The numbers of iNOS positive cells in the treatment and prevention groups were both lower than those of their corresponding control groups, which was in accord with the improvement of clinical signs and tissue lesions. The levels of nitrite in the supernatant of MNC culture of the treatment and prevention groups were higher than those of their corresponding control groups, but not significantly. Conclusion Administration of 1, 25-(OH)2D3 rapidly ameliorates EAE symptoms by promoting the apoptosis of inflammatory cells. The elimination of infiltrating immune cells which reverses the pathological changes in central nervous system is associated with a favorable microenvironment provided by 1,25-(OH)2D3, such as decreasing of iNOS.

Objective To evaluate the security and effectiveness of uterine artery embolization (UAE) in treatment of pregnancy in uterine caesarean scar compared with medicine treatment. Methods Sixty patients with pregnancies in uterine caesarean scar were divided into medicine group ( n = 31 ) that received intravenous injection of methotrexate (MTX) 100 mg once or MTX 20 mg once a day for 5 days as the first course, received the second course when the serum 13-human chorionic gonadotropin (HCG) decreased to the level as < 50%, and then underwent uterine curettage; and UAE group (n = 29) that underwent catheterization into the left uterine artery and then uterine curettage 48h after the successful embolization. The bleeding volume during suction curettage, side effects, admission day, and menstruation recover time were recorded. Results The hospital stay of the UAE group was ( 14.4±1.67 ) days, significantly shorter than that of the medicine group [ (39.3±4.71 ) days, P<0.05]. No patient had to receive hysterectomy in the UAE group but 2 in the medicine group underwent hysterectomy. Seven patients showed liver dysfunction and 8 patients had nausea and slight vomit in the medicine group, and 15 patients with fever and 10 with light post-embolization syndromes were found in the UAE group. Menstruation resumed normal in all patients of the 2 groups one or two months later. Conclusion With the advantage of low risk of heavy bleeding and shorter admission day, UAE is safe and effective in treatment of pregnancy in uterine caesarean scar.

A 20-year-old male was admitted to hospital on March 29, 2007, mainly due to "intermittent headache, limb twitching for 6 months, speech disorder for more than 10 days, aggravated for 1 week".

A 29-year-old female was admitted to the emergency department on December 30, 2007 due to intermittent fever for 1 week and massive vaginal bleeding for 5 days. The patient developed intermittent fever (specific body temperature unknown) without trigger 1 week ago, accompanied by sore throat and dry cough, occasionally accompanied by chills, and took 4 tablets of "Phenamamine Tablets" intermittently, but the symptoms were not relieved. Two days later, dull pain in the lower abdomen and massive vaginal bleeding (10 days earlier than normal menstruation) appeared, with the amount of about 200-400ml/d, lasting for about 5 days.