Impact of endometriosis on embryo quality and endometrial receptivity in women undergoing assisted reproductive technology

ART is an important treatment method for infertile patients with endometriosis. However, the effects of endometriosis on embryo quality and endometrial receptivity remain unclear. Thus, we aimed to simultaneously investigate the impact of endometriosis and its stage on embryo quality and endometrial receptivity in women undergoing ART. We retrospectively analyzed the data from patients with and without endometriosis who underwent oocyte retrieval and/or high-quality embryos transfer between July 2015 and December 2020, including 1312 IVF cycles and 608 IVF or frozen-thawed embryo transfer (FET) cycles, respectively. The endometriosis group had a lower percentage of good cleavage-stage embryos and fertilization rates than those in the control group (p = 0.038 and 0.008, respectively). The number of retrieved oocytes, MII oocytes, cleavage, blastocysts, and blastulation rates was comparable between two groups. We found no significant difference in clinical pregnancy, implantation, live birth, miscarriage, or multiple pregnancy rates between the two groups among patients who transferred high-quality embryos. Stratification analysis showed that patients with stage III-IV endometriosis had fewer retrieved oocytes than those with stage I-II endometriosis (p = 0.012) and marginally fewer retrieved oocytes than the control group (p = 0.051). The stage I-II group had the lowest percentage of good cleavage-stage embryos, which was significantly lower than that of the control group (p = 0.043). In FET cycles, patients with stage III-IV endometriosis had a higher miscarriage rate than those in the control group (p = 0.023). Our results suggest that endometriosis does not alter endometrial receptivity but affects embryo quality, oocyte fertilization ability, and ovarian response.     

雷帕霉素联合紫杉醇对子宫内膜癌STAT3 表达的影响

目的:探讨雷帕霉素联合紫杉醇对子宫内膜癌STAT3表达的影响及其临床意义。方法:选取我院收治的子宫内膜癌患者90例,随机分为对照组及实验组,对照组采用常规化疗治疗,实验组采用雷帕霉素联合紫杉醇化疗治疗。观察并比较两组患者治疗前后细胞生长抑制率以及干扰素、生长因子、白细胞介素及STAT3水平的变化情况。结果:与治疗前比较,两组患者治疗后细胞生长抑制率、生长因子、白细胞介素及STAT3表达水平均降低,而干扰素水平升高,差异具有统计学意义(P0.05);与对照组比较,实验组患者治疗后细胞生长抑制率、生长因子、白细胞介素及STAT3表达水平较低,而干扰素水平较高,差异具有统计学意义(P0.05)。结论:雷帕霉素联合紫杉醇可改善机体免疫功能活性,增强肿瘤细胞免疫活性,阻断细胞恶性增殖有丝分裂进程,提高吞噬细胞对肿瘤细胞杀伤性,临床疗效较化疗优异,可作为临床有效治疗方案,并具有重要意义。     

人蜕膜组织子宫内膜干细胞的分离、培养及鉴定

目的:研究人蜕膜组织中子宫内膜干细胞(endometrial stem cells,EnSCs)的分离、培养及鉴定方法。方法:取人工流产患者的蜕膜组织,用胰酶和II型胶原酶消化分离子宫内膜细胞,计数后,以极低密度接种于10 cm培养皿,分离单克隆贴壁细胞。倒置显微镜观察EnSCs形态变化及克隆形成情况;CCK-8法绘制EnSCs生长曲线,计算倍增时间;流式细胞仪分析EnSCs细胞周期及表面抗原CD29、CD31、CD34、CD44、CD45、CD73、CD90、CD105、CD146表达情况。结果:EnSCs呈长梭形,成纤维细胞样,可见粗细不等的胞质突起,增殖至80-90%呈漩涡状生长,其克隆形成率分别为3.91%和9.14%;EnSCs生长曲线呈"S"型,接种48 h至60 h后进入对数生长期,于第9天达到平台期,倍增时间为37-52 h;流式细胞仪测定EnSCs表面抗原CD29(99.13%),CD44(97.39%),CD73(99.68%),CD90(96.76%),CD105(89.64%),CD146(77.96%)呈阳性表达,而CD31(1.30%),CD34(0.68%),CD45(1.26%)呈阴性表达,有61.79%的细胞处于G0/G1期,22.37%的细胞处于S+G2/M期。结论:采用组织消化法分离单克隆贴壁的子宫内膜细胞,能够获得纯化的EnSCs。     

子宫内膜癌中TGF-β1及受体TβRI的表达及其临床意义

目的：研究转化生长因子（TGF-β1）及其Ⅰ型受体（TβRI）在子宫内膜癌组织中的表达及其临床意义。方法：采用RT-PCR方法检测36例子宫内膜癌及31例正常子宫内膜组织中TGF-β1及TβRI基因的表达水平,分析其与临床病理参数之间的关系。结果：子宫内膜癌组织中TGF-β1mRNA的表达明显高于正常组织（P〈0.05）,而TβRI mRNA的表达水平明显低于正常内膜组织（P〈0.05）。TGF-β1mRNA及TβRImRNA在子宫内膜癌中的表达均与肿瘤的临床分期、组织学分级、肌层浸润深度、淋巴结转移呈显著性相关（P〈0.05）,差别有统计学意义。结论：TGF-β1及其Ⅰ型受体TβRI在子宫内膜癌的发生、发展中可能起重要作用,检测TGF-β1及TβRI对评价子宫内膜癌的转移及预后有重要价值。     

PTEN蛋白在子宫内膜癌中的表达及其临床意义

目的　探讨抑癌基因PTEN产物PTEN蛋白在由正常子宫内膜过渡至子宫内膜癌过程中的表达缺失情况及其临床意义。方法　用SP免疫组化法测定 73例子宫内膜癌、 2 5例子宫内膜非典型增生、 71例子宫内膜增殖症和 31例正常子宫内膜组织中PTEN蛋白的表达 ,并与组织学类型、组织学分级、肌层浸润深度和临床分期等生物学行为进行相关分析。结果　PTEN蛋白在子宫内膜腺癌和癌前病变中的表达缺失率分别为 6 6 6 7%和 76 0 0 % ,表达缺失率与组织学类型(P <0 0 0 5 )和组织学分级有关 (P <0 0 5 ) ,与子宫内膜癌肌层浸润深度和临床分期无关 (P >0 0 5 )。结论　PTEN表达缺失是子宫内膜癌发生的早期分子事件 ,PTEN蛋白表达缺失是早期诊断子宫内膜癌及癌前病变较好的生物标志。     

In situ estimation of ephyrae liberated from polyps of Aurelia aurita using settling plates in Tokyo Bay, Japan

The continuous changes in the number of newly established polyps of Aurelia aurita (L.) on settling plates under natural conditions were observed from August 1998 to September 1999 in Tokyo Bay, Japan. A sharp decline in survivorship of newly settled polyps was observed within the first few days, however, survivorship of polyps settled in October increased by budding up to 399% after two months. The number of discs in each strobila varied from 1 to 6, however, most of the strobilae formed single discs. The percentage ratios of the total number of ephyrae to the initial number of polyps on settling plates were generally lower than 10%, but the highest ratio of 594.4% was estimated for the polyps settled in October. It is considered that most of the liberated ephyrae originate from the polyps settled in October in Tokyo Bay. This study suggests that the occurrence of ripe medusae with planula larvae throughout the year contributes to the success of settlement and growth of the polyp stage in Tokyo Bay.     

大鼠子宫宫腔粘连模型的建立及评价指标

子宫内膜损伤是导致宫腔粘连的最主要原因,建立有效的子宫内膜损伤动物模型是研究此类疾病发生、发展和治疗反应等不可或缺的支撑条件。通过宫腔注射95%的乙醇制造大鼠(Rattus norvegicus)子宫内膜损伤模型,检测胚胎植入数目来分析子宫内膜损伤对大鼠生育情况的影响,观察大鼠子宫内膜厚度、腺体数量和纤维化面积,分析乙醇处理对子宫内膜的影响;检测细胞角蛋白(CK-19)和波性蛋白(Vimentin)的表达水平,分析上皮细胞和间质细胞的增殖分化及子宫内膜损伤程度。结果显示,正常组大鼠子宫比损伤组更为平滑且有韧性,与正常组相比,损伤组大鼠生育率显著降低(P0.01),子宫内膜厚度变薄(P0.01)、腺体数量显著减少(P0.01),纤维化面积显著增大(P0.01),CK-19和Vimentin表达量显著下调。结果提示已成功建立大鼠子宫内膜损伤动物模型。     

子宫内膜癌手术治疗的研究进展

子宫内膜癌是妇科常见恶性肿瘤之一,手术是其主要的治疗方式。尽管开腹手术是治疗子宫内膜癌的传统方式,但随着医学科技的不断发展以及人们对术后生活质量要求的提高,妇科肿瘤的外科治疗方式也随之发生了革命性的变化。从传统开腹手术、腹腔镜手术、单孔腔镜技术,到2005年美国FDA批准应用于妇科手术的达芬奇机器人手术系统,子宫内膜癌的手术治疗方式也有了更多的选择。与传统开腹手术相比,微创手术凭借其创伤小、恢复快等优点,在子宫内膜癌的应用越来越广泛,但临床应用时间较短,仍需大样本多中心的长期随访研究来证实其安全性和有效性。本文主要围绕以上几种手术方式治疗子宫内膜癌的最新观点及研究进展进行综述。     

抑癌基因PTEN及其假基因PTENP1在子宫内膜癌中的研究进展

子宫内膜癌的发病率在逐年上升,引起了人们的广泛关注,但其发病的分子遗传学机制仍不十分清楚。近年来基因改变致癌的研究成为热点。国内外研究报道发现：PTEN（与张力蛋白同源第10染色体丢失的磷酸酶基因）是目前已知的子宫内膜癌中突变率最高的基因,常发生在子宫内膜癌的早期,对其突变的检测有助于子宫内膜癌的早期诊断、治疗及预后评价,并为子宫内膜癌的基因治疗提供了新的靶点。另外,研究发现,PTENP1（PTEN的假基因）转录调控PTEN的表达,被认为与一些肿瘤的发生有关。本文就PTEN基因的结构、功能及在子宫内膜癌中的突变情况、临床意义及PTENP1的研究现状进行综述。     

Calcium and calcium-related proteins in endometrial cancer: opportunities for pharmacological intervention

Intracellular calcium ions are key second messengers and play an important role in malignant transformation and cancer progression. Estrogen can evoke intracellular calcium increases through membrane-initiated effects and activate subsequent kinase cascades within minutes in normal and cancerous epithelial cells. Ca²⁺-related proteins are expressed in normal epithelial cells or endometrial cancer cells, some of which are upregulated by estrogen. Both estrogen-induced transient calcium increases and long-term changes in protein expression levels may be involved in regulating cancer initiation, progression and metastasis. Calcium channel blockers are reported to regulate both the rapid estrogen-induced intracellular Ca²⁺ increase and cell proliferation, apoptosis and migration, thus having the potential for pharmacological modulators to be repurposed for the treatment of endometrial cancer.