冷冻胚胎移植周期中内膜形态及内膜厚度对妊娠结局的预测价值分析

目的:评价内膜厚度及内膜形态对于体外受精-胚胎移植中冷冻胚胎解冻复苏移植的临床妊娠结局的预测价值。方法:回顾性分析1521个冷冻胚胎解冻复苏移植周期,将患者按子宫内膜厚度分为4组,子宫内膜≤6 mm、6.1-8.0 mm、8.0-12 mm、12.0 mm,根据子宫内膜形态分为A型内膜、B型内膜、C型内膜。分别比较不同内膜厚度分组及不同内膜形态分组患者的年龄,移植胚胎数目、内膜准备方案构成比、移植胚胎类型(卵裂期胚胎、囊胚)构成比及各组间的临床妊娠率和活产率。采用ROC曲线分析子宫内膜厚度、形态对临床妊娠结局的预测价值。使用逐步回归分析内膜厚度、形态、年龄及移植胚胎类型与妊娠结局的相关性。结果:纳入1521个解冻复苏周期中按内膜厚度分为4组,各组周期数分别为96周期、454周期、893周期、78周期,各组间平均年龄分别为34.1±5.5岁、33.3±5.4岁、32.5±5.2岁、33.7±6.0岁(P0.05)。内膜厚度≤6 mm组临床妊娠率为31.3%,子宫内膜≤6mm、6.1-8.0 mm、8.0-12 mm、12.0 mm组临床妊娠率分别为48.5%、51.8%、47.4%(P0.05)。子宫内膜≤6 mm、6.1-8.0 mm、8.0-12 mm、12.0 mm组间活产率分别为18.8%、37.7%、44.6%、39.7%(P0.05)。A型、B型及C型内膜组周期数分别为920周期、189周期及412周期,三组间平均年龄分别为32.3±5.1、33.0±5.7、34.2±5.5岁(P0.05)。A型/B型及C型内膜组临床妊娠率分别为51.2%、46.6%及46.4%,三组间活产率分别为42.1%、36.0%及37.1%,三组间差异无统计学意义(P0.05)。子宫内膜厚度ROC曲线下面积为0.534(95%可信区间0.505-0.564),子宫内膜形态ROC曲线下面积为0.526(0.476-0.955)。逐步回归分析纳入内膜厚度、内膜形态、年龄、胚胎类型4个可变量,女方年龄(OR=0.929,P0.001),移植胚胎中囊胚比例(OR=1.595,P0.001)与临床妊娠率明显相关,内膜厚度(OR=1.054,P=0.05)及内膜形态(OR=0.864)与临床妊娠率无相关性。结论:虽然子宫内膜薄临床妊娠率下降,但是子宫内膜厚度与内膜形态不能够预测体外受精-胚胎移植解冻复苏周期临床妊娠率,患者年龄以及移植胚胎的发育潜能才是预测临床妊娠率的参考指标。     

Hsa_circ_0002577 promotes endometrial carcinoma progression via regulating miR-197/CTNND1 axis and activating Wnt/β-catenin pathway

Circular RNA (circRNA) is involved in a wide range of life processes including tumorigenesis. However, the molecular mechanisms of circRNA in endometrial carcinoma (EC) carcinogenesis remain unclear. In the present study, we aimed to investigate the potential modulation of hsa_circ_0002577 on EC progression. Here, we showed that hsa_circ_0002577 expression was significantly upregulated in EC tissues, and high hsa_circ_0002577 expression was associated with advanced FIGO stage, lymph node metastasis, and poor overall survival rate of EC patients. In function assays, we demonstrated that hsa_circ_0002577 knockdown significantly reduced EC cells proliferation, migration, invasion ability in vitro and decreased tumor growth in vivo. In mechanism study, we revealed that hsa_circ_0002577 might act as a sponge for miR-197, and CTNND1 was revealed to be a target gene of miR-197. In addition, we revealed that the oncogenic effects of hsa_circ_0002577 were attributed to the regulation of miR-197/CTNND1/Wnt/β-catenin axis. Taken together, we indicated that hsa_circ_0002577 could play critical functions by hsa_circ_0002577/miR-197/CTNND1/Wnt/β-catenin signaling pathway, which served as a novel therapeutic application for EC treatment.     

钵水母水螅体横裂诱发条件及调控机制研究进展

横裂是水螅体世代向水母体世代转变的重要阶段.对水螅体横裂诱发条件及调控分子机制的研究不仅对水母爆发生态学和水母人工繁育具有重要意义,而且对比较研究两栖类、昆虫以及刺胞动物等具有复杂生活史生物的变态分子机制起源也具有很好的理论价值.现有研究表明,诱发水螅体横裂的自然环境因素有温度、光照、盐度和共生虫黄藻等,不同门类水母的横裂方式以及环境诱导因素各不相同.能够诱导水螅体横裂的化学因素有吲哚类化合物、9-顺式维甲酸、碘元素和过氧化氢等,其中吲哚类化合物对绝大多数水母水螅体都有诱导作用.尽管水螅体横裂的分子机制尚未明晰,但对海月水母的研究表明,RxR信号通路以及一种横裂诱导激素前体假定蛋白CL390在水母横裂过程中起着重要的作用,提示水母变态分子机制与两栖类和昆虫在分子水平上存在一定程度的共性.     

Effect modification of body mass index on the association between ovarian cysts and endometrial cancer

BackgroundOvarian cysts represent a common condition among women. Epidemiologic studies are inconsistent in determining if women with cysts are more likely to develop endometrial cancer (EC) regardless of overweight/obesity. We investigated the combined role of cysts and body mass index (BMI) on EC risk.MethodsWe pooled data from three case-control studies conducted in Italy and Switzerland on 920 women with EC and 1700 controls. The prevalence of cysts was 5% among both cases and controls, with 63% of cases being overweight/obese. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression models, adjusting for potential confounders. We conducted stratified analyses according to BMI, and estimated the interaction between cysts and BMI; we carried out additional analyses according to age at diagnosis of cysts.ResultsOverall, history of cysts was not associated to EC (OR=1.27, 95% CI=0.82–1.97, P = 0.29). Normal weight women reporting cysts had an increased risk of EC (OR=2.49, 95% CI=1.31–4.74), while no such effect was found among overweight/obese women (OR=0.65, 95% CI=0.36–1.18; P for interaction=0.004). The association was limited to women below 65 years of age and was stronger in those who reported cysts at age 48 or older.ConclusionsCysts appeared to be a risk factor for EC in lean women but not in overweight/obese ones; these results are consistent with an effect of cysts and obesity on EC along common pathways.     

子宫内膜癌组织KIF20A、LAPTM4B-35表达与临床病理特征及预后的关系研究

摘要 目的：探讨子宫内膜癌组织驱动蛋白家族成员20A(KIF20A)、溶酶体相关4次跨膜蛋白B-35(LAPTM4B-35)表达与临床病理特征及预后的关系。方法：选择2012年4月至2015年8月期间于我院行手术治疗的80例子宫内膜癌患者作为研究对象。检测子宫内膜癌组织以及距离肿瘤边缘2 cm以上癌旁组织中KIF20A、LAPTM4B-35 mRNA表达水平。分析子宫内膜癌组织中KIF20A、LAPTM4B-35 mRNA表达与临床病理特征的关系。分析不同KIF20A、LAPTM4B-35 mRNA表达患者5年总生存率的差异。分析子宫内膜癌患者预后的影响因素。结果：与癌旁组织相比,子宫内膜癌组织中KIF20A、LAPTM4B-35 mRNA表达水平明显升高,差异有统计学意义（P<0.05）。有淋巴结转移以及FIGO分期Ⅲ期患者的癌组织KIF20A、LAPTM4B-35 mRNA表达水平明显高于无淋巴结转移以及FIGO分期I～II期患者的癌组织,差异有统计学意义（P<0.05）。KIF20A低表达组患者5年总生存率明显高于KIF20A高表达组;LAPTM4B-35低表达组患者5年总生存率明显高于LAPTM4B-35高表达组患者,差异有统计学意义（P<0.05）。Cox回归分析结果显示：FIGO分期Ⅲ期、有淋巴结转移、KIF20A mRNA高表达和LAPTM4B-35 mRNA高表达是子宫内膜癌患者预后的影响因素（P<0.05）。结论：在子宫内膜癌组织中KIF20A、LAPTM4B-35 mRNA表达水平升高,有淋巴结转移、FIGO分期较高患者癌组织KIF20A、LAPTM4B-35 mRNA表达水平上调。KIF20A 、LAPTM4B-35高表达患者5年总生存率下降。     

宫腔镜下电切术与刮宫术治疗子宫内膜息肉合并不孕症的疗效比较及术后妊娠的影响因素分析

摘要 目的：比较宫腔镜下电切术与宫腔镜下刮宫术治疗子宫内膜息肉合并不孕症的疗效,并分析术后妊娠的影响因素。方法：选取2018年10月～2020年9月我院收治的318例子宫内膜息肉合并不孕症患者,其中接受宫腔镜下电切术治疗的159例归为电切术组,接受宫腔镜下刮宫术治疗的159例归为刮宫术组,术后均随访12个月,比较两组手术相关指标、子宫内膜厚度、月经量和围术期并发症、息肉复发率、临床妊娠率,多因素Logistic回归分析术后妊娠的影响因素。结果：电切术组术中出血量低于刮宫术组（P＜0.05）,两组患者手术时间、住院时间比较无差异（P＞0.05）。两组患者术后12个月子宫内膜厚度较术前降低,且电切术组术后子宫内膜厚度低于刮宫术组（P＜0.05）。两组患者术后1个月、术后3个月月经量较术前逐渐减少,且电切术组较刮宫术组变化更明显（P＜0.05）。电切术组息肉复发率低于刮宫术组,而临床妊娠率高于刮宫术组（P＜0.05）,两组患者围术期并发症总发生率比较差异无统计学意义（P＞0.05）。多因素Logistic回归分析结果显示,年龄≥35岁、多发息肉、息肉直径≥1 cm、宫角息肉、术后子宫内膜厚度≥13 mm、术后息肉复发是影响子宫内膜息肉合并不孕症患者术后妊娠的危险因素（P＜0.05）。结论：宫腔镜下电切术治疗子宫内膜息肉合并不孕症患者疗效较宫腔镜下刮宫术更为显著,其术后妊娠率受年龄、息肉类型、息肉直径、息肉部位、术后子宫内膜厚度、术后息肉复发等因素影响。     

胃炎性纤维性息肉的临床特征及内镜下诊治

摘要 目的：研究胃炎性纤维性息肉（IFP）的临床特征及内镜下诊断和治疗情况。方法：收集2010.1.1~2021.1.1陕西省人民医院确诊的11例IFP,重点分析其超声内镜表现及临床特征,探索其内镜下治疗价值。结果：IFP多发生在胃窦,均发生于40岁以上人群,男女比例无明显差别,平均直径1.2 cm,大部分临床无症状,有时可引起出血或腹痛。超声内镜示其为粘膜下隆起,孤立、界清,表面多光滑,均起源于粘膜下层,呈低回声,界清,类圆形;内镜下粘膜挖除术治疗IFP,手术时间短,恢复快,并获得完整的标本,术后病理有助确诊。结论：胃炎性纤维性息肉多发生40岁以上人群,多为胃窦孤立的粘膜下病变,多无症状,超声内镜有助于IFP的术前精确评估,内镜下粘膜挖除术是治疗IFP一项安全有效的方法,术后病理最终确诊。     

ICAM在着床期小鼠PBLC及EC/DC中表达的研究(英文)

细胞粘附分子（ＣＡＭ）可介导细胞间及细胞与间质之间的相互作用并传导信息,参与机体胚胎发育、免疫调节、炎症反应、组织修复及肿瘤转移等生理和病理过程。细胞间粘附分子１（ＩＣＡＭ１）是主要的ＣＡＭ分子之一,可表达于活化的细胞,内皮细胞等。人膜是母体与胚胎滋养层直接接触的特殊组织、已发现蜕膜细胞在着床过程中参与了局部免疫耐受的形成,但对着床期ＩＣＡＭ１在蜕膜细胞表达的动态研究鲜见报道。本研究采用免疫荧光、多参数流式细胞术,分别从整体和局部角度、着床过程中外周血淋巴细胞（ＰＢＬＣ）及子宫内膜／蜕膜（ＥＣ／ＤＣ）细胞ＩＣＡＭ１的不同表达特点进行了动态观察和对比性分析。结果发现,ＩＣＡＭ１在着床期ＰＢＬＣ及ＥＣ／ＤＣ中的表达均存在明显的动态变化（Ｔａｂ．１;Ｆｉｇｓ．１＆２）。ＩＣＡＭ１在ＰＢＬＣ中的表达于妊娠第一天（Ｄ１）即开始降低,Ｄ２降至最低;与此不同,ＩＣＡＭ１在ＥＣ／ＤＣ中的表达于Ｄ２开始降低,Ｄ４降至最低,Ｄ５开始恢复,但尚未恢复到对照水平。结果表明,ＩＣＡＭ１在蜕膜局部的表达调节方式不同于外周血;ＩＣＡＭ１表达阳性的外周血,淋巴细胞和蜕膜细胞均代表着活化的功能性细胞,这些细胞表面ＩＣＡＭ     

Prevalence, risk factors for and impact of subclinical endometritis in repeat breeder dairy cows

The aim of this study was to determine the prevalence and risk factors for subclinical endometritis (SE) and its effects on fertility in repeat breeder dairy cows. Dairy cows of parity 1 to 5 that were artificially inseminated (AI) 3 or more times (selected cows were artificially inseminated an average of 3.9 times) were examined at 190 ± 40 days in milk, and clinically normal cows (n = 77) were selected based on the absence of abnormal discharges on external inspection and the absence of abnormal findings on transrectal palpation and ultrasonographic examination. Endometrial samples were collected from the uterus by using the lavage technique in the luteal phase of the estrus cycle. Collected samples were centrifuged and a drop of sediment was streaked on to a clean microscopic slide and stained with Giemsa. The percentage of polymorphonuclear cells (neutrophils) was counted for each specimen. The analysed data showed that the average amount of neutrophils was 3.1% (0-9) in the selected cows. Abnormal calving (dystocia, twin births, and abortion), retained placenta, and postpartum uterine infections were associated with an increase in prevalence of SE. Subsequently, SE was significantly associated with a decrease in conception rate in the next AI. Conception rate in the next AI was 5% for cows (n = 38) with SE (≥ 3% neutrophil), and 47% for cows (n = 34) without SE (< 3% neutrophil) (P = 0.001). The prevalence of cytologically diagnosed SE (≥ 3% neutrophil) was 52.7% (n = 38). In conclusion, abnormal calving, retained placenta, and postpartum uterine infections may be associated with an increase in prevalence of SE and subsequently, SE may decrease reproductive performance and increase the incidence of repeat breeder syndrome.