子宫内膜异位症异位病灶神经分布的研究进展

子宫内膜异位症（endometriosis，EMs）导致的疼痛症状长期以来一直困扰着患者和医生。近年来，对疼痛产生的机制进行了大量研究，包括遗传、炎症介质等方面，研究发现，子宫内膜异位症在位与异位内膜存在异常的神经分布，这些神经涉及感觉神经A8，感觉纤维C，胆碱能和肾上腺素能神经纤维等，并且常与增生的血管伴行。神经与血管能分泌疼痛介质及炎症因子，局部的炎症因子和疼痛介质亦可促进神经与血管的增生。神经纤维增生可能在子宫内膜异位症患者疼痛症状的产生及子宫内膜异位症的发病机制中起重要作用，异常的神经分布也可为子宫内膜异位症的诊断及治疗提供参考。     

神经浸润与早期宫颈癌患者预后的相关性研究

疼痛属于子宫内膜异位症（endometriosis,EMs）有待解决的疑点和难点。关于EMs疼痛的发病机制,近年来国内外研究人员从多个角度进行了探讨,包括异常神经分布与疼痛、炎症介质引起疼痛以及机械牵拉性疼痛等,综述如下。     

巨噬细胞在子宫内膜异位症神经纤维及血管生成中的作用及机制

子宫内膜异位症（endometriosis,EMs）是育龄期女性常见疾病,其发病机制目前尚未明确,其中神经纤维及血管生成是促进疾病进展、产生慢性盆腔痛及子宫内膜异位病灶增大的重要机制,而其形成原因亦非常复杂,很可能与EMs免疫微环境的改变密切相关。而作为EMs免疫因素重要成分的巨噬细胞,在疾病发生、发展中异常募集并产生表型及功能的改变,分泌多种促炎及抗炎细胞因子,引起神经信号的过度兴奋和通路转导异常,并参与血管内皮生长因子（VEGF）通路的调控,对神经血管的生成有重要作用。总结在EMs中巨噬细胞表型功能变化对神经纤维异常生成及盆腹腔中血管增生的作用及其潜在机制,为针对巨噬细胞与EMs神经血管生成的靶向治疗可以干预炎症过程、周围神经和血管的生成提供理论支持,为解析EMs的发病机制提供新的思路。     

子宫内膜异位症患者在位子宫内膜神经纤维分布的研究

目的:研究子宫内膜异位症(EMT)患者的在位子宫内膜的功能层中神经纤维的分布状况.方法:选取2005年1月至2008年12月以痛经为主诉并行子宫切除的EMT患者25例为研究组,随机选取同期无此疾病的行子宫切除的患者40例作为对照组,利用免疫组织化学技术,使用多克隆家兔抗人抗蛋白基因产物9.5染色标记子宫在位内膜的神经纤维,用数码相机照相,分析其神经纤维密度.结果:在EMT患者子宫内膜的功能层中出现神经纤维,而非EMT患者子宫内膜的功能层中未出现神经纤维(P<0.01).结论:EMT患者子宫内膜的功能层中神经纤维异常增多,可能与EMT患者的疼痛症状有关.     

子宫内膜异位症在位子宫内膜神经纤维含量的研究

目的探讨子宫内膜异位症在位子宫内膜的神经纤维含量及与疼痛的相关性。方法选取2013年4月至2014年4月就诊于深圳市妇幼保健院,并通过腹腔镜手术确诊的子宫内膜异位症患者55例作为研究组,根据VAS评分分为疼痛组(38例)和无痛组(17例),同期因子宫肌瘤或CINⅢ级行全子宫切除并且不伴有痛经的患者30例作为对照组,收集上述患者的在位子宫内膜,采用免疫组化比较两组患者的在位子宫内膜中神经纤维的表达。结果子宫内膜异位症疼痛组患者的在位子宫内膜中的神经纤维表达明显高于无痛组和对照组(P0.05),并且内异症患者在位子宫内膜中神经纤维的表达与疼痛的严重程度有关(r=0.647,P0.05)。结论在位子宫内膜中神经纤维的表达与子宫内膜异位症患者的疼痛相关。     

子宫内膜异位症的血管生成与抗血管生成治疗

子宫内膜异位症发病机制不明.近年研究表明,新生血管形成是子宫内膜异位症发生发展的关键步骤,子宫内膜异位症患者体内某些血管生成因子活性增高或抑制因子活性降低,造成血管生成过度,促进异位内膜种植和生长.免疫系统、类固醇激素与血管生成有密切关联.目前子宫内膜异位症的治疗主要是传统的激素和手术治疗,具有较大不良反应及较高复发率,寻求新的治疗方法已成为研究热点,抗血管生成为治疗子宫内膜异位症开辟了新途径,值得进一步深入研究.     

肥大细胞在子宫内膜异位症相关性疼痛发病机制中的作用

子宫内膜异位症(EMs)是一种严重影响妇女心理和生理健康的妇科常见病。疼痛作为EMs的主要临床症状之一,其发病机制至今未明。肥大细胞是免疫炎症反应体系中的重要细胞之一,综述近年来有关EMs相关性疼痛发病机制的文献表明,EMs病灶中活化的肥大细胞数量显著增加,并通过与神经纤维相互作用、分泌炎症因子及促使盆腔粘连等在EMs相关性疼痛的发病机制中起重要作用,对其各种病理生理机制的研究将为预防和治疗EMs相关性疼痛开辟新的思路。     

神经生长因子在子宫内膜异位症疼痛中的作用

子宫内膜异位症(内异症)是指在子宫外出现子宫内膜样的腺体或间质.疼痛是内异症的症状之一,主要表现为痛经、性交痛、排便痛及慢性盆腔痛.内异症疼痛的机制尚未完全阐明,以往的研究认为,疼痛的类型和程度与内异症的分期、内异症病灶的大小、深度及生化指标无明显相关,而与前列腺素及激肽、组胺、白细胞介素(IL)等炎症介质的释放密切联系.     

子宫内膜异位症患者在位内膜异常改变的研究进展

子宫内膜异位症(endometriosis,EMS)是指子宫内膜组织(腺体和间质)出现在子宫腔以外的部位。EMS患者的在位内膜不同于正常子宫内膜,不仅在形态结构上发生了改变,在基因层面与分子生物学层面亦发生了多种改变,这些改变进而引起一系列在位子宫内膜功能上的变化,主要表现为EMS患者在位内膜细胞的黏附性、侵袭力、转移力、血管生成能力、细胞增殖能力增强,细胞凋亡能力与子宫内膜容受性下降,以及神经纤维分布异常,引发盆腔疼痛等。     

子宫内膜异位症的血管生成与抗血管生成治疗

子宫内膜异位症发病机制不明。近年研究表明，新生血管形成是子宫内膜异位症发生发展的关键步骤，子宫内膜异位症患者体内某些血管生成因子活性增高或抑制因子活性降低，造成血管生成过度，促进异位内膜种植和生长。免疫系统、类固醇激素与血管生成有密切关联。目前子宫内膜异位症的治疗主要是传统的激素和手术治疗，具有较大不良反应及较高复发率，寻求新的治疗方法已成为研究热点，抗血管生成为治疗子宫内膜异位症开辟了新途径，值得进一步深入研究。     

Abortion in France in 1977

This update of legal abortion in France begins with the history of abortion, the French abortion law, and application since its passage in 1975, and evaluates current acceptance by French physicians. In France, abortion was outlawed in 1923, with the highest numbers of convictions, 5521, in 1946. Increasingly since the late 1960s, the law was neither heeded nor enforced, resulting in a new liberalized law passed in 1975, and put into effect over the next 2 years. Some of the difficulties encountered in implementing legal abortion were: the decision to permit abortion only in approved hospitals, rather than to allow establishment of abortion clinics; resistance of many hospitals or individuals against performing abortions; fixed prices for physicians fees (160 F.) and quotas of 25% of the total surgical and obstetrical patient load; regional variations in availability of abortion; and waiting periods. These problems have led to continuation of black market abortions, fraud in reporting numbers of abortions performed, and have forced some women to travel to other regions of the country or to other countries to obtain safe abortions. Only the 1975 figures are available: there were 45,085 legal abortions, 32,923 in public hospitals and 12,792 in private hospitals. Abortions are easily obtained in large cities and the Southeast, Central and Breton regions but less so in the North and Southwest.     

Differences in female and male perception of information and decision-making in single-embryo transfer in in vitro fertilization in Sweden

Purpose The aim of this study was to evaluate the information and the factors that contribute to the decision to accept and choose single embryo transfer (SET) in females and males. Materials and methods Fifty-four females and males undergoing SET were interviewed separately using a structured questionnaire. Results The women were significantly more satisfied with the information than the men (odds ratio 3.3), but the decision to accept SET was nevertheless more difficult for women (OR 3.1). Only one-third of both female and males were aware of the increased maternal risks with twin pregnancies. There was a tendency that the women who accepted SET had previous children, shorter duration of infertility, and were younger. Cryopreservation of embryos and a good pregnancy chance were important irrespective of gender. Conclusion The female needs more support to choose SET. The male needs better information and further involvement in decision-making. The females were more aware of the fetal risks, but the awareness of the increased maternal risks with twin pregnancies was low. The female need more support to accept and choose single embryo transfer, compared to the male and information should in some areas be directed differently to females and males.