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Biomedical subjects

Jinghe Lang

Publications and source records attributed to Jinghe Lang.

26 records · Page 2Linked to original sources
PubMed2002

[Laparoscopic surgery in patients with hypovolemic shock due to ectopic pregnancy].

OBJECTIVE: To evaluate the feasibility and safety of operative laparoscopy for ectopic pregnancy with hypovolemic shock. METHODS: Two hundred and fifteen women with ectopic pregnancy underwent operative laparoscopy. These patients were divided into two groups. Group I included 21 patients of ectopic pregnancy with shock and intraperitoneal hemorrhage more than 1,000 ml, and group II included 194 hemodynamically stable patients with blood loss less than 1,000 ml. The clinical data of perioperative periods in two groups were analyzed. RESULTS: All patients were tube pregnancies. The rate of tube rupture was higher in group I than that in group II (81% versus 16%), the difference was statistically significant (P < 0.01). Intraabdominal blood loss was significantly higher in group I (1,775 +/- 531) ml than that in group II (133 +/- 176) ml, autologous blood transfusions were given to 95% and 9% of patients in group I and II respectively (P < 0.01). Laparoscopic salpingectomy was performed to 86% and 51% of patients in group I and II, the difference was significant. The operating time was longer in group I than in group II (50 +/- 24) and (43 +/- 24) min, but the difference was not significant. All patients had no perioperative complications. CONCLUSIONS: Operative laparoscopy in patients with hypovolemic shock can be safely and effectively performed by experienced laparoscopists with the aid of optimal anesthesia, advanced cardiovascular monitoring and autologous blood transfusion.

Adult↗
PubMed2002

[Evaluation of myometrial invasion in endometrial carcinoma].

OBJECTIVE: To determine the value of preoperative ultrasound, intraoperative gross visual inspection and postoperative bulk specimen measurement in evaluating the diagnosis of myometrial invasion in endometrial carcinoma. METHODS: A total of 133 cases of women with endometrial carcinoma were analyzed focusing on evaluating the diagnosis of myometrial invasion by preoperative ultrasound, intraoperative gross visual inspection and postoperative bulk specimen measurement. The relationship between CA(125) and endometrial carcinoma of 91 cases of endometrial carcinoma was also analyzed. RESULTS: In the diagnosis of myometrial invasion and deep myometrial invasion, ultrasound showed a sensitivity of 62.6% and 47.8% and a specificity of 67.7% and 90.0%, respectively, and intraoperative gross visual inspection showed a sensitivity of 59.6% and 73.9% and a specificity of 76.5% and 94.6%, respectively. The sensitivity of postoperative bulk specimen measurement was 70.0% and 94.4% and the specificity was 92.0% and 97.7%, respectively. The levels of CA(125) had no correlation with depth of myometrial invasion in endometrial carcinoma, but they had correlation with International Federation of Gynecology and Obstetrics (FIGO) stage. CONCLUSIONS: Preoperative ultrasound, intraoperative gross visual inspection and postoperative bulk specimen measurement were helpful to the diagnosis of depth of myometrial invasion in endometrial carcinoma, and postoperative bulk specimen measurement seems to be better. CA(125) could not evaluate depth of myometrial invasion in endometrial carcinoma.

Endometrial Neoplasms↗
PubMed2002

[Clinical analyses of 42 cases of urinary tract injury in gynecologic surgery].

OBJECTIVE: To determine the clinical characteristics and management of urinary tract injuries incidental to gynecologic surgery. METHODS: During the study period from Jan. 1, 1990 to Dec. 31, 2001, forty-two patients with urinary tract injuries in gynecologic surgery were analyzed retrospectively focusing on type and time of injury, diagnostic methods and managements of urinary fistula. RESULTS: Forty-two urological injuries were incurred during the performance of 12 849 gynecologic surgical procedures, an incidence of 0.33% including of 11 ureteral injuries and 31 bladder injuries, an incidence of 0.09% and 0.24% respectively. Of the 11 ureteral injuries 5 occurred in the lower ureter, 4 occurred at the level of vecical entrance and 2 were in the region of the infundibulopelvic ligaments. Of the bladder injuries, all 31 occurred at the bottom or back of the bladder. Urinary tract injury was made intraoperatively in 32 patients (76%) and made postoperatively in 10 patients (24%). Urinary fistulae occurred in 14 patients (33%). Ten patients with urinary fistulae were diagnosed by comparing the concentration of electrolyte, urea nitrogen and creatine in drainage fluid with those in urine and blood. Infusion of methylene blue and/or cystoscopy were checked in 9 patients and 4 bladder fistulae were found positive results. All 8 ureteral fistulae were diagnosed by intravenous pyelography. An appropriate repair during operation, putting the double J-catheter and/or catheterization was useful. Forty-one patients were healed. CONCLUSION: Most of urinary tract injuries in gynecologic surgery had optimal results when they were diagnosed early and managed correctly.

Female↗
PubMed2002

Clinical study on collagen and stress urinary incontinence.

OBJECTIVE: To investigate the histological characteristics in uterine ligaments of stress urinary incontinence (SUI) and pelvic organ prolapse (POP); to detect the alteration of collagen ultrastructure in uterine ligaments that contribute to SUI and POP; to study the relationship between collagen alteration and SUI and POP. METHODS: The cardinal ligament (Car lig.) and uterosacral ligaments (U-S lig.) samples were obtained from 73 subjects suffering from SUI, or normal controls who underwent hysterectomy. Collagen ultrastructure was examined with transmission electron microscopy (TEM). RESULTS: 1) The smooth muscle fascicles in the patients with SUI and POP were thinner. Arrangement of smooth muscle fascicles was in disorder. 2) The collagen constituting the ligaments was active in metabolism. The mean collagen fibril diameters in the SUI and POP groups were about 25% larger than that in the control groups (p < or = 0.01). 3) Histological characteristics of the Car lig. and the U-S lig. were similar. CONCLUSIONS: 1) The Car lig. and U-S lig. are homologous. Abnormalities in arrangement of smooth muscles and the collagen ultrastructure were obviously seen in SUI and POP 2) The collagen fibril diameter in the SUI and POP subgroups was significantly larger than that in the control groups. Those ligaments are probably less elastic and more likely to break. Predominance of collagen degradation during tissue repair may contribute to POP and SUI.

Adult↗
PubMed2002

[Transitional cell carcinoma of the ovary: one kind of uncommon type of ovarian epithelial carcinoma].

OBJECTIVE: To evaluated clinico-biologic behavior, prognosis and relative prognostic factors of transitional cell carcinoma of the ovary. METHODS: The clinical records of 58 patients with transitional cell carcinoma of the ovary, who received treatment in the department of Obstetrics and Gynecology, Peking Union Medical College Hospital in 20 years, were reviewed retrospectively. The data were analyzed statistically by SPSS 10.0. RESULTS: Among 58 cases, the median age was 55 +/- 10 (35 - 75) years old. 31% of them had bilateral ovary involvement, and the median level of CA(125) was (687 +/- 365) U/L. All patients received cytoreductive surgery in our hospital, 69% of them got optimal cytoreduction. Pathologic results showed that G(1), G(2), G(3) were 7%, 45% and 48% respectively, 40% were demonstrated lymph node metastasis. Nearly 80% of patients were classified to International Federation of Gynecology and Obstetrics (FIGO) stage III and IV. Different courses of chemotherapy were given to all patients. The recurrence occurred in 45% of cases and the death rate was 53%. The Cox hazards regression model was used to analyze the possible prognostic factors and revealed that tumor residuals (P < 0.01), preoperative level of CA(125) (P < 0.01), bilateral ovary involvement (P < 0.05) and lymph node metastasis (P < 0.05) were the most important prognostic factors. CONCLUSIONS: Transitional cell carcinoma of ovary is an uncommon type of ovarian cancer. It usually behaves better prognosis when compared with papillary serous cystadenocarcinoma of the ovary.

Adult↗
PubMed2002

Serum soluble E-cadherin level in patients with endometriosis.

OBJECTIVE: To investigate the serum sE-cadherin level in patients with endometriosis and the alterations of that level in healthy control during the menstrual cycle. METHODS: Thirty-two patients with endometriosis and 30 healthy women were tested for serum sE-cadherin levels by enzyme-linked immunosorbent assay. RESULTS: The serum sE-cadherin levels in healthy control did not vary throughout the menstrual cycle, which were lower than those in patients with endometriosis. CONCLUSIONS: E-cadherin might be involved in endometrial shedding during menstruation in endometriosis patients. The serum sE-cadherin assay might be helpful as a serum marker for the diagnosis and management of endometriosis.

Adult↗
PubMedDate not supplied

Study on nerve fiber density in anterior vaginal epithelium for stress urinary incontinence.

The aim of this study was to determine the relationship of innervation in anterior vaginal epithelium with the etiology of stress urinary incontinence (SUI). Fifty-three biopsy specimens of the anterior vaginal epithelium were obtained from 53 subjects in control, pelvic organ prolapse (POP) and SUI groups. Routine HE staining and immunohistochemical staining for protein gene product 9.5 (PGP9.5) were performed for all specimens. PGP9.5 immunoreactivity was identified in nerve fibers and cells of the epithelium and subepitheliual connective tissue of vagina. The nerve fiber profiles of vaginal epithelium in the SUI/POP groups were significantly lower than those in the control group (P < 0.05). There was no correlation between the nerve fiber profiles and parity in SUI, POP and control groups. Decrease of nerve fiber profiles in anterior vaginal epithelium might lead to the occurrence of SUI.

Adolescent↗