大鼠薄型子宫内膜模型的建立和鉴定

为探索宫腔注入无水乙醇建立薄型子宫内膜模型的可行性,将25只大鼠分3组:对照组(宫腔注入生理盐水),5分钟组(宫腔注入无水乙醇并贮留5 min),10分钟组(宫腔注入无水乙醇并贮留10 min),经测量子宫内膜变薄者为造模组,5分钟组有14个子宫内膜变薄,10分钟组无一例纳入造模组.免疫组织化学检测角蛋白、波形蛋白、血管内皮生长因子(vascular endothelial growth factor,VEGF)、雌激素受体α(estrogen related recep-tor alpha,ERα)的表达.结果发现5分钟组造模组与对照组单位内膜面积中角蛋白面积、单位间质面积中波形蛋白面积和子宫内膜中VEGF平均光密度差异有统计学意义(P<0.05),造模组与对照组子宫内膜ERα组织学积分无差异(P>0.05).表明宫腔注入无水乙醇并贮留5 min可以成功建立薄型子宫内膜模型,成功率为70%.     

NGF 及其受体TrkA 在子宫腺肌病中的表达及与痛经的关系

目的:研究NGF及其受体TrkA在子宫腺肌病患者的异位内膜与在位内膜组织的表达情况及与痛经的关系。方法:采用免疫组化MaxVision法检测子宫腺肌病异位内膜(30例)、在位内膜(30例)、正常子宫内膜(19例)标本中NGF、TrkA蛋白的表达,分析其表达差异及与痛经的关系。结果:①子宫腺肌病异位内膜组NGF、TrkA表达显著高于正常内膜组(P<0.01),在位内膜组NGF、TrkA表达显著高于正常内膜组(P<0.01),子宫腺肌病异位内膜组NGF、TrkA表达与在位内膜组无显著差异。②子宫腺肌病异位内膜组NGF、TrkA表达与痛经强度评分呈正相关(相关系数r=0.637,P=0.000;r=0.662,P=0.000)。结论:NGF及其受体TrkA在子宫腺肌病中高表达可能参与子宫腺肌病发病机制,而且可能与痛经有关。     

ER和PRmRNAs在内异症子宫内膜表达的变化

目的 :探讨雌激素受体 (ER)和孕激素受体 (PR)在子宫内膜异位症 (内异症 )子宫内膜的表达。方法 :利用大鼠内异症动物模型 ,采用逆转录聚合酶链反应 (RT PCR)技术 ,检测子宫内膜ER和PRmRNAs的表达情况。结果 :内异症模型组大鼠异位内膜ER、PRmRNAs的表达低于在位内膜和对照组正常子宫内膜 ,与后两者比较差异有显著性意义 (P <0 .0 1) ;而模型组在位内膜ER、PRmRNAs的表达与正常对照组比较差异无显著性意义 (P >0 .0 5 )。内异症模型组异位内膜ER/PRmRNA比值大于在位内膜和正常子宫内膜ER/PRmRNA比值 (P <0 .0 1)。结论 :内异症大鼠异位内膜ERmRNA表达的相对增高在内异症的发生与发展中起着一定的作用。     

AT2R载体可调控表达对大鼠颈动脉损伤后骨桥蛋白及新生内膜增生的影响

目的:血管紧张素Ⅱ 2型受体(AT2R)基因转染的骨髓间充质干细胞(MSC)在四环素可调控系统下作为载体,利用计算机图像分析系统研究新生内膜增生的情况,并探讨AT2R在体可调控表达对大鼠颈动脉损伤后骨桥蛋白(OPN)表达影响。方法:利用球囊损伤60只SD大鼠颈动脉,并随机将SD大鼠分为5组,分别为正常组(未行球囊扩张术)、对照组(球囊扩张术后注入PBS)、MSC组(球囊扩张术后注入常规MSC)、MSC转染组(球囊扩张术注入转染AT2R的MSC)、强力霉素(Dox)组(球囊扩张术后注入转染AT2R的MSC,术后当天至处死前三天通过尾静脉注射Dox 100μg/kg/d)。术后14及28天分别处死大鼠取材,光镜下观察血管内膜增生情况,Image pro plus 6.0计算机图像分析系统测量新生内膜面积(I/M),逆转录-多聚酶链反应(RT-PCR)检测AT2R及OPN在大鼠血管标本中的表达变化。结果:大鼠颈动脉AT2R在Dox组的表达显著增高,新的增生内膜面积较其它各损伤组显著降低(P≤0.01),并且OPN的表达显著低于其他各手术组。结论:AT2R基因在体可调控表达受到Dox的有效控制,AT2R基因可能抑制血管损伤后OPN的表达及新生内膜的过度增生。     

薄型子宫内膜模型的动物选择及其造模方法改进

薄型子宫内膜是影响体外受精-胚胎移植的一个重要因素,而目前对于薄型子宫内膜的治疗缺乏有效的治疗手段。探讨稳定有效的薄型子宫内膜的动物模型,可为探索薄型子宫内膜疾病发病机制及治疗研究提供实验基础。本文从国内外多种动物子宫内膜损伤模型造模方法进行分析探讨,总结出大鼠宫腔内注射95%乙醇是目前比较适合用于薄型子宫内膜模型的建立,并在该法基础提出一些经验总结和改进的方法。     

Bcl-2在EMT模型大鼠中药治疗前后异位组织中的表达

目的观察细胞凋亡调控蛋白Bcl-2在子宫内膜异位症(endometriosis,EMT)模型大鼠异位组织中的表达,探讨"消症汤"促进异位组织消退的作用机理,为临床用药提供实验依据.方法制作大鼠EMT动物模型,模型鼠每日分别以0.5ml和1.0ml中药灌胃,采用免疫组化方法观察用药前后在位和异位子宫内膜组织中Bcl-2的表达.结果 Bcl-2在各组在位和异位组织中的上皮细胞、腺细胞、基质细胞、白细胞以及巨噬细胞中均有表达,且模型对照组中阳性细胞数大于正常对照组和1.0ml用药组(P＜0.01)."消症汤"治疗前后,巨噬细胞数无显著差异(P＞0.05),而Bcl-2阳性表达的巨噬细胞渐减(P＜0.01).结论子宫内膜中Bcl-2 的高表达可能抑制了异位组织细胞凋亡,而"消症汤"降低了Bcl-2蛋白水平,后者可能与促进细胞凋亡有关.     

大黄素靶向Notch通路抗腹膜透析大鼠腹膜纤维化

长期腹膜透析治疗经常并发腹膜纤维化,本文旨在探讨大黄素对腹膜透析相关性腹膜纤维化大鼠的治疗作用及其相关的细胞、分子机制。在体内实验中,以腹腔注射4.25%葡萄糖腹膜透析液(100 m L/kg)诱发大鼠腹膜透析相关性腹膜纤维化动物模型,于2周、4周、6周时进行模型大鼠腹膜平衡实验,并测量腹膜厚度、应用HE染色和Masson染色进行组织病理学评估,ELISA法测定血浆中III型前胶原氨基端肽(PIIINP)水平。选取6周模型大鼠,用大黄素腹腔注射进行治疗,观察治疗后上述指标的变化,同时以Real-time PCR方法检测大鼠腹膜Notch1、Jagged-1、Hes-1基因表达水平,Western blot方法检测大鼠腹膜组织Notch1、Jagged-1、Hes-1、Notch胞内结构域(Notch intracellular domain,NICD)蛋白表达。在体外实验中,培养大鼠腹膜间皮细胞,使其过表达或沉默Notch1,Western blot检测大黄素对腹膜间皮细胞Hes-1、Hey的诱导表达作用。HE染色显示:随着造模时间的延长,间皮细胞减少、部分脱落,间质有炎细胞浸润,6周时Masson染色显示模型组腹膜明显增厚(P0.01),可见大量胶原沉积。与对照组相比,6周模型组大鼠血浆PIIINP水平显著升高(P0.01)。与6周模型组相比,大黄素处理可增加模型大鼠腹膜组织中间皮细胞数量,抑制腹膜增厚(P0.01),改善胶原沉积,降低血浆PIIINP水平(P0.05),并在基因、蛋白水平下调Notch1、Jagged-1、Hes-1的表达(P0.05或P0.01),且下调NICD蛋白水平(P0.01);体外实验显示:与正常细胞大黄素处理组相比,大黄素对过表达Notch1间皮细胞的Hes-1、Hey表达具有抑制作用(P0.05),而对Notch1沉默间皮细胞的Hes-1、Hey表达无明显影响(P0.05)。以上结果表明,在高浓度葡萄糖腹膜透析液所致的大鼠腹膜纤维化模型中有Notch通路的活化,大黄素可能通过抑制Notch通路改善腹膜纤维化程度。     

内皮抑素转基因治疗子宫内膜异位症大鼠模型的实验研究

目的:了解内皮抑素(ES)转基因治疗子宫内膜异位症大鼠模型的疗效。方法:构建子宫内膜异位症大鼠模型,选择建模成功的大鼠为实验研究对象,随机分为ES转染组(I组)24只、载体对照组(Ⅱ组)20只和阴性对照组(Ⅲ组)20只。I组病灶局部注射lipofectamine-endo-pBud复合物进行基因转染,Ⅱ组注射lipofectamine-pBud复合物,Ⅲ组注射PBS用于对照。通过实时荧光定量PCR法检测异位病灶中ES基因的相对表达量,用Western-blot测定ES-HA融合蛋白及ES蛋白的相对表达量,来判断转染成功与否。用ELISA法对大鼠血清中ES及血管内皮细胞生长因子(VEGF)水平进行测定,用免疫组化SP法对ES、基质金属蛋白酶-2(MMP-2)以及微血管密度(MVD)的表达进行测定,用游标卡尺对转染前后各组大鼠异位病灶的长、宽进行测量,计算体积,分析各指标实验前后的差异,观察内皮抑素转基因治疗子宫内膜异位症大鼠模型的疗效。结果:注射相应试剂后2周,I组异位病灶组织中ES基因的相对表达量高于两对照组(P<0.05),有ES-HA融合蛋白表达,且ES蛋白的相对表达量显著高于两对照组(P<0.01);I组血清中ES水平显著高于两对照组(P<0.01),VEGF水平显著低于两对照组(P<0.01),三组ES与VEGF在血清中的表达水平呈负相关(r=-0.805);I组异位病灶组织中ES表达明显高于两对照组(P<0.01);MMP-2的表达明显少于两对照组(P<0.01);MVD明显少于两对照组(P<0.01);三组ES与MMP-2在异位内膜中的表达呈负相关(r=-0.700);I组异位病灶体积明显小于两对照组(P<0.01)。结论:阳离子脂质体LipofectamineTM2000介导的重组质粒endo-pBud病灶内直接注射法可以成功实现ES在子宫内膜异位症大鼠异位内膜中的表达,并对子宫内膜异位症大鼠模型有治疗作用。     

NGF及其受体TrkA在子宫腺肌病中的表达及与痛经的关系

目的：研究NGF及其受体TrkA在子宫腺肌病患者的异位内膜与在位内膜组织的表达情况及与痛经的关系。方法：采用免疫组化MaxVision法检测子宫腺肌病异位内膜（30例）、在位内膜（30例）、正常子宫内膜（19例）标本中NGF、TrkA蛋白的表达,分析其表达差异及与痛经的关系。结果：①子宫腺肌病异位内膜组NGF、TrkA表达显著高于正常内膜组（P〈0.01）,在位内膜组NGF、TrkA表达显著高于正常内膜组（P〈0.01）,子宫腺肌病异位内膜组NGF、TrkA表达与在位内膜组无显著差异。②子宫腺肌病异位内膜组NGF、TrkA表达与痛经强度评分呈正相关（相关系数r=0.637,P=0.000;r=0.662,P=0.000）。结论：NGF及其受体TrkA在子宫腺肌病中高表达可能参与子宫腺肌病发病机制,而且可能与痛经有关。     

Doxy对大鼠动脉内膜损伤后MMP-1表达影响的研究

目的:观察动脉内膜损伤后基质金属蛋白酶-1(MMP-1)的表达变化,探讨Doxy和MM-1对动脉内膜损伤后再狭窄的影响.方法:建立大鼠颈总动脉损伤模型,治疗组用多西环素30mg·kg-1·d-1干预,免疫组化测定损伤动脉中MMP-1的表达,弹力纠维染色观察损伤动脉内膜面积、管腔面积的情况.结果:①MMP-1阳性指数于损伤后3d表达最高,以后逐渐减少,28d时达最低值,Doxy治疗组MMP-1表达的阳性指数3d,7d,14d均低于手术组(P＜0.01),而28d则与手术组无明显差别(P＞0.05).②内膜面积自术后7 d开始增加,28d后达最高值,管腔面积自术后7 d开始减少,28d后达最低值.Doxy治疗组14 d及28 d内膜面积明显小于手术组,管腔面积明显大于手术组,具有显著差异(P＜0.01).结论:动脉内膜损伤后MMP-1强烈表达,Doxy可以显著降低血管损伤后前2周MMP-1的表达,提示它可能防治动脉内膜损伤后再狭窄而不需长期给药.     

Reconstruction of functional endometrium-like tissue in vitro and in vivo using cell sheet engineering

Uterus is a female specific reproductive organ and plays critical roles in allowing embryo to grow. Therefore, the endometrial disorders lead to female infertility. Hence, the regeneration of endometrium allowing fertilized ovum to implant might be valuable in the field of fertility treatment. Recently, cell sheet engineering using a temperature-responsive culture dish has advanced in regenerative medicine. With this technology, endometrial cells were harvested as a contiguous cell sheet by reducing temperature. Firstly, mouse endometrial cell sheets were re-cultured for 3 days to evaluate the function. Histological analyses revealed that endometrial epithelial cell-specific cytokeratin 18 and female-specific hormone receptors, estrogen receptor β and progesterone receptor, were expressed. Furthermore, endometrial epithelial cells constructed epithelial layer at the apical side. Then, endometrial cell sheets from green-fluorescent-protein rat cells were transplanted onto the buttock muscle of nude rat for evaluating the function in vivo. Histological analyses showed that endometrial cell sheets reconstructed endometrium-like tissue, which was found to form uterus-specific endometrial glands having hormonal receptor to estrogen. In this study, endometrial cell sheets were speculated to contribute to the regeneration of functional endometrium as a new therapy.     

Use of Granulocyte Colony-Stimulating Factor for the Treatment of Thin Endometrium in Experimental Rats

Granulocyte colony-stimulating factor (G-CSF) induces stem cells to mobilize to the injury site, which have beneficial effect on tissue repair. The aim of this study was to investigate the effect of G-CSF on the thin endometrium in rat models. In the present study, rats with thin endometrium were divided into 4 groups (experimental group I: administrated with G-CSF (40 µg/kg/d) 4–6 hours post-modeling; control group I: administrated with saline 4–6 hours post-modeling; experimental group II: administrated with G-CSF (40 µg/kg/d) 12 days post-modeling; control group II: administrated with saline 12 days post-modeling. The agentia was given once daily and last for 5 days. Endometrial morphology was analyzed by Hematoxylin-Eosin staining, and the regeneration of endometrial cells was evaluated by immunohistochemistry and western-blot with cytokeratin and vimentin. We found that endometrial thickness and morphology presented a significant difference between experimental groups and control groups. No matter when we start with G-CSF, there was a significantly thicker endometrium and stronger expression of cytokeratin/vimintin in the experimental groups compared with the control groups (P<0.01). There were significant thicker endometrial lining and stronger expression of cytokeratin/vimintin in experimental group I than that of experimental group II (P<0.05), but there was no difference in the endometrial lining and the expression of cytokeratin/vimintin between the two control groups (P>0.05). In conclusion, G-CSF can promote the regeneration of endometrial cells in animal research, especially when the G-CSF was administrated earlier.     

Gastrin-releasing peptide (GRP) in the ovine uterus: regulation by interferon tau and progesterone

Gastrin-releasing peptide (GRP) is abundantly expressed by endometrial glands of the ovine uterus and processed into different bioactive peptides, including GRP1-27, GRP18-27, and a C-terminus, that affect cell proliferation and migration. However, little information is available concerning the hormonal regulation of endometrial GRP and expression of GRP receptors in the ovine endometrium and conceptus. These studies determined the effects of pregnancy, progesterone (P4), interferon tau (IFNT), placental lactogen (CSH1), and growth hormone (GH) on expression of GRP in the endometrium and GRP receptors (GRPR, NMBR, BRS3) in the endometrium, conceptus, and placenta. In pregnant ewes, GRP mRNA and protein were first detected predominantly in endometrial glands after Day 10 and were abundant from Days 18 through 120 of gestation. Treatment with IFNT and progesterone but not CSH1 or GH stimulated GRP expression in the endometrial glands. Western blot analyses identified proGRP in uterine luminal fluid and allantoic fluid from Day 80 unilateral pregnant ewes but not in uterine luminal fluid of either cyclic or early pregnant ewes. GRPR mRNA was very low in the Day 18 conceptus and undetectable in the endometrium and placenta; NMBR and BRS3 mRNAs were undetectable in ovine uteroplacental tissues. Collectively, the present studies validate GRP as a novel IFNT-stimulated gene in the glands of the ovine uterus, revealed that IFNT induction of GRP is dependent on P4, and found that exposure of the ovine uterus to P4 for 20 days induces GRP expression in endometrial glands.     

Pregnancy-related changes in the human endometrium revealed by lectin histochemistry

The binding of 22 fluorescein isothiocyanate (FITC) conjugated lectins to human proliferative phase and pregnant endometrium was studied histochemically. Only the lectin from Bauhinia purpurea (BPA) reacted exclusively with the epithelial cells. All the others reacted to a certain extent with glandular and/or stromal cells. Lectins from soybean (SBA), and Vicia villosa seeds (VVA) reacted with endometrial glands of pregnancy but not with the glands of the proliferative endometrium. In the proliferative endometrium SBA reacted only with cells of the surface endometrium. Lectin from peanuts (PNA) reacted only with some glands in the proliferative endometrium but was unreactive with others. In pregnant endometrium PNA reacted with all glands. Lectins from lentils (LCA) and red kidney beans (PHA-E and PHA-L) reacted with endometrial glands of the proliferative phase but not with the glands from pregnant endometrium. We thus show that FITC labeled lectins define specific carbohydrate moieties selectively expressed on either proliferative phase or pregnant endometrial glands.     

Cytomorphology and histomorphology after thermal endometrial ablation. Early changes

OBJECTIVE: Endometrial thermal balloon ablation is a recent technique for treatment of dysfunctional uterine bleeding. Although the histologic features of thermal injury to the endometrium have been documented, the cytologic features are not described in the literature. In this study, the cytomorphology of recent thermal injury was studied and correlated with histomorphology. STUDY DESIGN: The study consisted of 29 cases divided into 3 groups: (1) control group, hysterectomies without ablation; (2) specimen (in vitro) group, where ablation was carried out on the uteri in the immediate postoperative period; and (3) in vivo group, with intraoperative endometrial ablation. The cytotoxic effect of thermal injury was assessed by staining the smears for oxidative enzymes. RESULTS: The cytomorphologic features of in vivo thermal ablation were characteristic and composed of fragmented glands, numerous single cells with fuzzy cytoplasm and giant cells. Staining for dehydrogenases was absent from > 90% of endometrial cells in the in vivo cases as against 100% positivity in the control group. CONCLUSION: The cytomorphologic features described for the first time in this study can be applied to endometrial aspirate or brush smears to evaluate the efficacy of the technique and follow-up.     

Endometrial contraception: modulation of molecular determinants of uterine receptivity

Modulation of endometrial receptivity is a promising approach for fertility regulation since it allows a contraceptive to act specifically at the endometrium. This was corroborated by our previous observations that treatment with low doses of a pure progesterone antagonist (PA, antiprogestin), onapristone (ZK 98299), in bonnet monkeys inhibited fertility by selectively retarding endometrial development, without affecting the hypophyseal-hypothalamic function. In the present study, further investigations, undertaken to analyze the molecular repertoire of a nonreceptive primate endometrium, determined expression of: steroid hormone receptors, i.e. progesterone receptor (PR) and estrogen receptor (ER); cytokines, i.e. leukemia inhibitory factor (LIF): transforming growth factor beta (TGFbeta) and its receptor (TGFbetaR); and cell adhesion molecules, i.e. integrins (alpha(v)beta(3), alpha(1)beta(1)). These studies were conducted during the different phases of the normal menstrual cycle and following treatment with different doses of onapristone (2.5 mg, 5 mg, or 10 mg every third day for one cycle) in bonnet monkeys. The molecules were analysed collectively to explore the possibility of a correlation between expression of these markers and endometrial receptivity and to investigate whether there exists a regulatory link between expression of these molecules under in vivo conditions. Three types of expression patterns of endometrial factors were observed during the peri-implantation period following onapristone treatment: 1) LIF, alpha(v)beta(3), and alpha(1)beta(1) showed significant (P < 0.02) down regulation in glandular epithelium of endometria in animals treated with all three doses of onapristone as compared to the control group. This was indicative of their critical role in the progesterone-driven cascade leading to implantation. 2) PR, TGFbeta, and TGFbetaR remained unaffected in the endometria from 2.5 mg treated animals and showed down regulation in animals treated with 5 and 10 mg onapristone as compared to the control group, thereby suggesting that the expression of these markers may not truely reflect endometrial receptivity per se. However, their facilitatory role in preparing the endometrium for implantation can not be ruled out since continued perturbation in the expression of these molecules may affect endometrial growth, remodelling, and differentiation, which in turn may render the endometrium nonreceptive; 3) ER remained unaltered in endometria of animals rendered infertile with 2.5, 5, and 10 mg onapristone. This observation indirectly suggests that onapristone-induced endometrial changes are mediated via some specific mechanisms. The present study clearly demonstrates that endometrial non-receptivity induced at low doses of onapristone is associated with changes in the expression pattern of specific molecular markers. However, no direct correlation was observed between in vivo expression of TGFbeta, LIF, and integrins, thereby lending support to the concept that there exists redundancy or multiple pathways which regulate implantation events.     

人滋养细胞表面抗原（Trop-2）在病变子宫内膜中表达的研究

摘要 目的：探讨人滋养细胞表面抗原（trophoblast cell-surface antigens2,Trop-2）在病变子宫内膜中的表达及其临床相关性。方法：采用免疫组化法检测100例正常子宫内膜或病变子宫内膜组织中Trop-2蛋白的表达,其中单纯增生子宫内膜患者26例,复杂或不典型增生子宫内膜患者34例,子宫内膜腺癌患者20例,对照组为20例增生期子宫内膜患者。结果：免疫组织化学法研究结果显示,Trop-2蛋白在正常增生子宫内膜和单纯性增生子宫内膜中几乎不表达,在复杂或不典型增生子宫内膜组织中以及子宫内膜腺癌呈阳性表达。主要分布在细胞膜上,阳性率分别为35.29 %和65.00 %,经过对比子宫内膜癌组的阳性表达率显著高于复杂型或伴不典型增生子宫内膜组的阳性表达率（P<0.05）,且复杂型或伴不典型增生子宫内膜组的阳性表达率显著高于单纯性增生子宫内膜组（P<0.05）,其表达水平随内膜病变程度的加重而升高,呈正相关关系（P＜0.05）。结论：Trop-2蛋白在子宫内膜病变中的表达与其严重程度一致,可反映子宫内膜病变的发生发展,或可作为判断其严重程度的指标。