苍砂白芥汤结合GnRH-a治疗子宫肌瘤疗效及对其卵巢功能、血清bFGF、NF-κB水平影响

摘要 目的：探讨苍砂白芥汤结合GnRH-a治疗子宫肌瘤疗效及对其卵巢功能、血清bFGF、NF-κB水平影响。方法：选取2019年5月至2021年5月于我院接受治疗的110例子宫肌瘤患者为本次研究对象,将患者分为观察组和对照组,每组55例。对照组患者接受GnRH-a治疗,观察组接受苍砂白芥汤结合GnRH-a治疗,对比两组临床治疗总有效率、孕酮（P）水平、卵泡刺激素（FSH）水平、雌二醇（E₂）水平、血管内皮生长因子（VEGF）水平、碱性成纤维细胞生长因子（bFGF）水平、基质金属蛋白酶3（MMP-3）水平、核转录因子-κB亚型P65（NF-κB P65）水平、肿瘤特异性生长因子（TSGF）水平。结果：观察组总有效率较对照组高（P<0.05）;两组治疗前P、FSH、E₂水平比较无差异（P>0.05）,两组治疗后P、FSH、E₂水平均有所下降,且观察组均低于对照组（P<0.05）;两组患者治疗前VEGF、bFGF、MMP-3水平比较无差异（P>0.05）,两组患者治疗后VEGF、bFGF、MMP-3水平均有所降低,且观察组均低于对照组（P<0.05）;两组治疗前NF-κB P65、TSGF水平比较无差异（P>0.05）,两组治疗后NF-κB P65、TSGF水平均有所下降,且观察组低于对照组（P<0.05）。结论：使用苍砂白芥汤结合GnRH-a治疗子宫肌瘤,可提高临床治疗效果,调节性激素水平,改善VEGF、bFGF、MMP-3、NF-κB P65、TSGF水平,值得临床推广使用。     

Genomic modulation of diabetes (<Emphasis Type="Italic">db/db)</Emphasis> and obese (<Emphasis Type="Italic">ob/ob</Emphasis>) mutation-induced hypercytolipidemia: cytochemical basis of female reproductive tract involution

Infertility and hypercytolipidemic utero-ovarian involution are recognized consequences of the diabetes-obesity syndrome (DOS) in C57BL mice with either obese (ob/ob) or diabetes (db/db) single gene mutations. We have evaluated the interdependent deleterious influences of both mutation types and differences in the genomic background on utero-ovarian dysfunction in C57BL mice. Control (+/?) C57BL mice were matched with littermate ob/ob and db/db mutants expressed on either the /KsJ or /6 background. Both ob/ob and db/db mutations increased body weights of /KsJ and /6 background strains relative to +/? groups. In contrast, uterine and ovarian weights were depressed by ob/ob and db/dbmutations relative to +/?, regardless of the background strain, but especially when expressed on the /KsJ background. Functionally, both ob/ob and db/db mutations induced hyperglycemic-hyperinsulinemic states coupled with depressed serum estradiol-17-β and progesterone concentrations when expressed on a /KsJ background. Microscopic analysis of utero-ovarian tissue samples revealed marked hypercytolipidemia in the follicular granulosa and endometrial epithelial tissue layers of both ob/oband db/db mutant groups relative to normal +/? cytoarchitecture. The db/db mutation consistently promoted more severe hypercytolipidemic profiles than the ob/obmutation, regardless of background strain. Thus, the severity of utero-ovarian hypercytolipidemia following the expression ofob/ob and db/db mutations in C57BL mice is influenced, or moderated, by the genomic background on which the mutation is expressed.     

Venusol from Gunnera perpensa: structural and activity studies

From the aqueous extract of the dry rhizomes of Gunnera perpensa the minor components pyrogallol, succinic acid, lactic acid, and the trimethyl ether of ellagic acid glucoside were isolated. The major constituent was identified as Z-venusol, a phenylpropanoid glucoside. Its structure was verified by X-ray diffraction. Tests on isolated uterine smooth muscle from rats showed that the whole extract stimulated a direct contractile response and induced a state of continuous contractility of the uterus once all additives had been removed from the organ bath. By contrast, venusol did not trigger the direct contractile response but induced the state of continuous contractility once the organ bath was flushed.     

Secretory proteins in the reproductive tract of the snapping turtle, Chelhydra serpentina

SDS-polyacrylamide gel electrophoresis was used to separate the secretory proteins produced by the epithelial and endometrial glands of the uterine tube and uterus in the snapping turtle Chelydra serpentina. The proteins were analyzed throughout the phases of the reproductive cycle from May to August, including preovulatory, ovulatory, postovulatory or luteal, and vitellogenic phases. The pattern of secretory proteins is quite uniform along the length of the uterine tube, and the same is true of the uterus, but the patterns for uterine tube and uterus are clearly different. We identify 13 major proteins in C. serpentina egg albumen. Bands co-migrating with 11 of these are found in the uterine tube, but at most 4 are found in the uterus, suggesting that the majority of the albumen proteins are most likely secreted in the uterine tube, not in the uterus. Although some of the egg albumen proteins are present in the uterine tube only at the time of ovulation, most of the bands corresponding to albumen proteins are present throughout the breeding season even though the snapping turtle is a monoclutch species. These results suggest that the glandular secretory phase in the uterine tube is active and quite homogeneous in function regardless of location or phase of the reproductive cycle.     

The expression of HPV-16 E5 protein in squamous neoplastic changes in the uterine cervix

To investigate the expression of human papillomavirus type 16 (HPV-16) E5 protein in squamous neoplastic changes in the uterine cervix, the specific E5 antibody was generated and used to identify the expression of E5 protein in 40 cases of HPV-16-positive tissues and 5 previously identified HPV-negative normal cervical tissues. The results revealed that E5 protein was primarily expressed in the lower third of the epithelium in low-grade squamous intraepithelial lesions (SILs) and throughout the whole epithelium in high-grade SILs. In invasive squamous carcinoma, 60% of HPV-16-infected cancers which contained the episomal viral genome had the E5 gene, and could express E5 protein which was located throughout the whole epithelium. Previously, we documented the expression of type I growth factor receptors [ERBB1/EGFR (epidermal growth factor receptor), ERBB2, ERBB3 and ERBB4] in the full range of cervical neoplasias by immunohistochemistry assay. Hence, in this study, we extensively analyzed the correlation between the expression of E5 protein and the expression of type I growth factor receptors. Among 40 HPV-16- infected cervical neoplasias, we found that the expression of E5 protein was significantly correlated with either the expression of the ERBB1 or the ERBB4 receptor.     

剖宫产瘢痕妊娠治疗方案的探讨

目的:探讨剖宫产瘢痕妊娠(CSP)的合理治疗方案。方法:回顾性分析2007年1月至2013年12月我院收治的26例CSP患者的临床资料,对其病史、临床表现、处理及结局进行总结分析,重点探讨其治疗方案与预后的关系。结果:采用的治疗方式包括口服米非司酮配伍米索前列醇后超声监测下清宫术6例、超声监测下局部甲氨蝶呤注射3例、全身甲氨蝶呤注射后清宫术2例、子宫动脉(化疗)栓塞后清宫术16例、经腹病灶切除术1例、经腹全子宫切除术1例。前三种方法尽管具有一定的成功率,但均有较高的术后大出血风险。子宫动脉(化疗)栓塞在CSP的初始及抢救治疗中均具有很高的成功率。结论:CSP治疗方案的选择需根据患者的病情、妊娠部位、生育要求等多方面进行综合考虑。在现有的治疗方案中,子宫动脉(化疗)栓塞后清宫术具有较大的优势。     

Conceptus ecobiometry and triplex Doppler ultrasonography of uterine and umbilical arteries for assessment of fetal viability in dogs

The objectives were to: 1) evaluate blood flow in the uterine (UA) and umbilical (Uma) arteries in the pregnant bitch, by measuring the resistive index (RI) and pulsatility index (PI); 2) to note the presence or absence of the early diastolic notch and diastolic flow in the UA and Uma flow waveforms, respectively; and 3) perform conceptus ecobiometry for fetal growth assessment during pregnancy. Six healthy bitches were examined on approximately Days -44, -42, -36, -31, -28, -25, -21, -18, -14, -8, -4, and -2 of pregnancy (whelping = Day 0). Triplex Doppler and B-mode ultrasonography were used to assess blood flow and conceptus ecobiometry. All pregnancies ended with a normal whelping and birth of live puppies. Prior to whelping, all conceptus dimensions increased significantly, whereas RI and PI of both the Uma and UA decreased significantly. For the UA, RI and PI were (mean ± SEM) 0.95 ± 0.02 and 2.75 ± 0.41, respectively, on Day -44, and were 0.60 ± 0.01 and 0.99 ± 0.03 on Day -4. For the Uma, RI and PI were 0.99 ± 0.01 and 2.42 ± 0.03 on Day -31, and were 0.62 ± 0.01 and 1.15 ± 0.02 on Day -4. The complete disappearance of the early diastolic notch in the UA, and the appearance of diastolic flow in the Uma occurred on Days -16 ± 5 and -21 ± 1. The authors concluded that UA and Uma perfusion were important end points to assess fetal vitality in bitches. Furthermore, the current reference values provided a baseline for monitoring normal and abnormal pregnancies in bitches.     

影响经动脉子宫颈癌热灌注化疗临床疗效的多因素分析

目的:探讨宫颈癌热灌注化疗栓塞的治疗作用及对临床疗效的影响因素分析。方法:对34例宫颈癌病人进行子宫动脉热灌注化疗及栓塞术,分析肿瘤病理类型,肿块大小,周围浸润及淋巴结转移情况等因素对介入治疗的影响。结果:经过对临床疗效的多因素分析肿块大小对治疗效果影响最大,其次为病理类型。其余影响较小。结论:宫颈癌热灌注化疗栓塞术是治疗宫颈癌的一种适合疗法,尤其适用于肿块较小的病人。可以使疾病得到有效控制,增加手术机会。     

子宫肌瘤复发的相关因素分析

目的:探讨子宫肌瘤剔除术后复发的相关因素,为临床降低复发率提供科学依据和有效途径.方法:收集2002年1月至2010年12月北京市怀柔区第一医院妇科门诊收治的445例子宫肌瘤剔除术患者的临床资料及子宫肌瘤术后复发随访情况,对相关因素进行单因素和多因素logistic分析.结果:随访的445例患者复发94例,复发率为21.12％,复发距手术时间6～96个月,平均(38.5±12.8)个月.年龄、BMI、肌瘤数目、肌瘤大小、肌瘤部位、既往分娩史、术后用药与肌瘤复发显著相关,其中年龄、BMI、肌瘤数目是子宫肌瘤复发的独立危险因素,术后妊娠是子宫肌瘤复发的保护因素.结论:年龄、BMI、肌瘤数目是子宫肌瘤复发的独立危险因素,术后妊娠是保护因素.     

Age-dependent Increases of Calcium, Phosphorus, and Sodium in the Uterine Arteries of Thai

To elucidate compositional changes of the uterine artery with aging, the authors investigated age-related changes of elements in the uterine arteries of Thai. After ordinary dissection by medical students at Chiang Mai University was finished, the uterine arteries were resected from Thai subjects. Thai subjects ranged in age from 27 to 86 years (average age = 63.3 +/- 17.7 years). The element content of the uterine arteries was analyzed by inductively coupled plasma-atomic emission spectrometry. It was found that the Ca, P, and Na contents increased progressively in the uterine arteries of Thai with aging. A significant accumulation of Ca and P in the uterine arteries of Thai was found in the sixties patients, and the accumulation increased markedly in the seventies. Regarding the uterine arteries in subjects more than 60 years, the extent of accumulation of Ca and P in the uterine arteries of Thai was one half of that in the uterine arteries of Japanese. Regarding the relationships among elements, extremely significant direct correlations were found among the contents of Ca, P, Mg, Zn, and Na in the uterine arteries of Thai. As Ca increased in the uterine arteries of Thai, P, Mg, Zn, and Na increased simultaneously in the arteries.