神经内镜手术与小骨窗开颅手术治疗高血压脑出血疗效对比的回顾性研究

摘要 目的：回顾性对比神经内镜手术与小骨窗开颅手术治疗高血压脑出血（HICH）疗效。方法：回顾性选取2018年7月~2021年3月期间在联勤保障部队第909医院治疗的83例HICH患者的临床资料。根据手术方式的不同,将患者分为A组（n=41）和B组（n=42）,A组患者采用小骨窗开颅手术治疗,B组患者采用神经内镜手术治疗,对比两组围术期指标、并发症发生率、神经功能、生活能力、神经损伤指标及预后。结果：与A组相比, B组的手术时间、住院时间明显缩短,术中出血量减少,血肿清除率升高（P<0.05）。B组术后1周美国国立卫生研究院卒中量表（NIHSS）评分低于A组,Barthel指数评分高于A组（P<0.05）。B组术后1周神经元特异性烯醇化酶（NSE）、S100B 蛋白（S100B）、髓鞘碱性蛋白（MBP）、胶质纤维酸性蛋白（GFAP）水平低于A组（P<0.05）。B组的并发症发生率小于A组（P<0.05）。B组的预后良好率高于A组（P<0.05）。结论：神经内镜手术、小骨窗开颅手术治疗HICH均可获得较好的疗效,其中神经内镜手术在缩短手术时间、住院时间,减少术中出血量和并发症发生率,提高血肿清除率,减轻神经功能损伤,促进患者生活能力改善,改善患者预后方面的效果更为显著。     

腹腔镜与经腹子宫肌瘤剔除术对有生育要求子宫肌瘤患者妊娠结局的影响及术后妊娠率的影响因素分析

摘要 目的：研究腹腔镜与经腹子宫肌瘤剔除术对有生育要求子宫肌瘤患者妊娠结局的影响及术后妊娠率的影响因素。方法：选取我院2018年4月至2021年4月收治的80例有生育要求的子宫肌瘤患者,其中接受经腹子宫肌瘤剔除术治疗的40例归为经腹组,接受腹腔镜子宫肌瘤剔除术治疗的40例归为腹腔镜组。比较两组手术疗效指标,术后并发症发生率以及术后妊娠率。此外,80例患者根据出院后1年是否妊娠分为妊娠组和未妊娠组,以多因素Logistic回归分析术后妊娠率的影响因素。结果：在术后失血量、肛门恢复排气时间以及住院时间方面比较,腹腔镜组均优于经腹组（P＜0.05）。腹腔镜组术后并发症发生率低于经腹组（P＜0.05）,两组术后妊娠率对比无统计学差异（P＞0.05）。单因素分析结果显示：年龄、肌瘤数目和子宫肌瘤剔除术患者术后是否妊娠有关（P＜0.05）,而孕次、肌瘤类型、肌瘤最大直径以及穿透宫腔与否和子宫肌瘤剔除术患者术后是否妊娠无关（P＞0.05）。多因素Logistic回归分析结果显示：年龄≥35岁以及肌瘤多发是子宫肌瘤剔除术患者术后未妊娠的危险因素（P＜0.05）。结论：腹腔镜与经腹子宫肌瘤剔除术对有生育要求子宫肌瘤患者妊娠结局的影响程度相当,但腹腔镜术式有助于患者术后康复,同时降低并发症发生风险。此外,年龄较大和肌瘤数目较多会使子宫肌瘤剔除术患者术后妊娠难度增加。     

不孕症患者的子宫自然杀伤细胞、浆细胞与子宫内膜异位症的相关性

摘要 目的：探究不孕症患者的子宫自然杀伤细胞、浆细胞与子宫内膜异位症的相关性。方法：选择80例患有子宫内膜异位症的不孕症患者做为本研究的不孕症组和80例正常生育的健康女性做为本研究的健康组,对比分析两组患者人口学基本资料、子宫自然杀伤细胞（uNKs）、浆细胞（PC）水平、血清性激素水平、子宫内膜中血管内皮生长因子（VEGF）表达情况、免疫细胞水平。通过Person法分析不孕症患者的子宫自然杀伤细胞、浆细胞与子宫内膜异位症的相关性。结果：两组的BMI指数、流产史、吸烟史、饮酒史比较,差异有统计学意义（P<0.05）;不孕症组患者uNKs、抗苗勒氏管激素（AMH）和黄体生成素（LH）水平均显著高于健康组;PC、卵泡刺激素（FSH）、雌激素（Estrogen）和性激素结合球蛋白（SHBG）、VEGF阳性表达水平、CD4⁺、CD8⁺和CD4⁺/CD8⁺水平均显著低于健康组,差异有统计学意义（P<0.05）。另外,不孕症患者的uNKs与子宫内膜异位症存在显著的正相关关系（r=1.555,P<0.001）;PC与子宫内膜异位症存在显著的负相关关系（r=-3.778,P<0.001）。结论：不孕症患者的uNKs、PC参与不孕症的发生和发展过程,对女性子宫内膜异位症的诊断具有重要的参考意义。     

腹腔镜下子宫血管阻断术联合子宫肌瘤剜除术治疗子宫肌瘤的回顾性研究

摘要 目的：回顾性分析子宫肌瘤剜除术联合腹腔镜下子宫血管阻断术治疗子宫肌瘤的临床疗效。方法：分析2017年6月~2019年7月期间我院收治的子宫肌瘤患者的临床资料（n=150）。根据手术方法的不同将患者分为A组（腹腔镜下子宫肌瘤剜除术治疗,73例）和B组（腹腔镜下子宫血管阻断术联合子宫肌瘤剜除术治疗,77例）,对比两组术中、内分泌激素、术后恢复指标、妊娠情况、并发症发生率及复发率。结果：两组患者手术时间对比无统计学差异（P>0.05）,B组的术中出血量少于A组,术后排气时间、住院天数、下床活动时间短于A组（P<0.05）。A组术前、术后3个月、术后6个月黄体生成素(LH) 、卵泡刺激素(FSH) 、雌二醇(E₂) 水平组内对比无统计学差异（P>0.05）。B组术前、术后3个月、术后6个月E₂水平呈降低后升高趋势,LH、FSH水平呈升高后降低趋势（P<0.05）。B组术后3个月LH、FSH水平高于A组,E2水平低于A组（P<0.05）。与A组相比,B组的并发症发生率明显下降,组间对比有差异（P<0.05）。B组的妊娠率高于A组,子宫肌瘤复发率低于A组（P<0.05）。两组流产率组间对比无统计学差异（P>0.05）。结论：与单纯子宫肌瘤剜除术相比,结合腹腔镜下子宫血管阻断术治疗子宫肌瘤患者可减少术中出血量,促进患者术后恢复,降低并发症发生率及复发率,虽然其对卵巢功能有轻微、短暂性影响,但可逐步恢复,且有利于提高妊娠率。     

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 role of thrombin and thrombin receptors in ischemic,hemorrhagic and traumatic brain injury: deleterious or protective?

In the last two decades it has become apparent that thrombin has many extravascular effects that are mediated by a family of protease-activated receptors (PARs). PAR-1, -3 and -4 are activated via cleavage by thrombin. The importance of extravascular thrombin in modulating ischemic, hemorrhagic and traumatic injury in brain has recently become clear. Thus, in vitro, thrombin at low concentration protects neurons and astrocytes from cell death caused by a number of different insults. In vivo, pretreating the brain with a low dose of thrombin (thrombin preconditioning), attenuates the brain injury induced by a large dose of thrombin, an intracerebral hemorrhage or by focal cerebral ischemia. Thrombin may also be an important mediator of ischemic preconditioning. In contrast, high doses of thrombin kill neurons and astrocytes in vitro and cause disruption of the blood-brain barrier, brain edema and seizures in vivo. This review examines the role of thrombin in brain injury and the molecular mechanisms and signaling cascades involved.     

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.