羊膜细胞培养液对胎儿卵巢组织雌二醇分泌的实验研究

目的观察胎儿卵巢在体外培养条件下及羊膜细胞培养液条件培养液对分泌雌二醇(E2)的影响,旨在为卵巢移植提供较好的供体培养方法。方法取20～28周妊娠水囊引产的胎儿卵巢,将其切成碎块进行一般培养液直接培养(A组)及加羊膜细胞培养液培养(B组)。培养后测定两种不同培养液中E2含量并进行比较。结果胎儿卵巢在一般培养液和加羊膜细胞培养液培养条件下能产生E2,随培养时间延长,E2分泌量增加。而加羊膜细胞培养液组E2分泌量高于一般培养液直接培养(P<0.05)。结论胎儿卵巢在一般培养液培养条件下能分泌E2,而加羊膜细胞培养液能促进培养的卵巢组织的E2分泌,可作为卵巢移植的供体培养的较好培养液。     

uPA及PAI-1在卵巢上皮性肿瘤组织中的表达和活性

目的:探讨卵巢上皮性肿瘤组织中尿激酶型纤溶酶原激活物(uPA)及其抑制物1(PAI-1)的表达与活性及其临床意义。方法:免疫组化SABC法检测35例恶性卵巢上皮性肿瘤及12例良性卵巢上皮性肿瘤组织uPA和PAI-1蛋白质的表达,发色底物法检测肿瘤组织uPA活性。结果:恶性卵巢上皮性肿瘤uPA、PAI-1的表达明显高于良性卵巢上皮性肿瘤,恶性卵巢上皮性肿瘤中PA活性明显高于良性卵巢上皮性肿瘤(P<0·01);在组织学分型中随恶性卵巢上皮性肿瘤分化程度的降低uPA、PAI-1的表达逐渐升高(P<0·01),uPA活性逐渐升高(P<0·05);在临床分期晚的病例中uPA、PAI-1的表达及uPA活性较临床分期早的病例高(PAP<0·05;PAIP<0·01;uPA活性P<0·05)。结论:uPA、PAI-1与卵巢恶性上皮性肿瘤的分化、转移及浸润有关,可能做为恶性卵巢上皮性肿瘤诊治的靶点。     

HCV抗原在慢性HCV感染者卵巢及输卵管组织中表达的研究

目的:探讨慢性丙肝病毒(HCV)感染者卵巢及输卵管组织中HCV的存在及分布。方法:用免疫组化法检测慢性HCV感染者卵巢及输卵管组织内HCV抗原的表达及分布。结果:HCV抗原表达于卵巢的间质细胞、颗粒细胞及血管内皮细胞,HCV在输卵管组织中分布于上皮细胞及间质细胞。阳性信号主要分布于细胞膜、细胞浆及细胞核内。结论:HCV可感染卵巢及输卵管组织,推测可能与HCV母婴传播有关。     

子宫动脉栓塞治疗子宫腺肌病对卵巢功能的影响

目的:探讨子宫动脉栓塞治疗子宫腺肌病对卵巢功能的影响。方法:对27例子宫腺肌病患者采用聚乙烯醇微粒(PVA)进行子宫动脉栓塞治疗,在栓塞前、栓塞后3个月及6个月,评估所有病人的症状改善情况,并且采用经阴道彩色能量多普勒超声对子宫及病灶进行动态监测,监测子宫大小,子宫动脉和卵巢动脉血流动态改变,及基础性激素水平和基础体温情况。结果:子宫动脉栓塞术后3个月,子宫体积显著减小,平均缩小136.48(37.6%),子宫动脉的最大血流速度Vmax(cm/s)显著降低,由(27.27±6.03)cm/s降至(14.19±5.98)cm/s,P<0.05。子宫动脉阻力指数(RI)由0.54±0.03降至0.86±0.04,P<0.05;栓塞术前、后卵巢血流、卵泡刺激素(FSH)、雌二醇(E2)和月经周期无显著性差别。1例患者出现短暂卵巢功能急剧减退。结论:子宫动脉栓塞治疗子宫腺肌病是一种新颖、微创、安全、有效、并发症少且恢复快的治疗方法,可保留子宫的生育功能,对卵巢功能无明显损害,但应注意可能导致卵巢衰竭。     

大鼠双侧卵巢腹腔及皮下移植的形态与功能研究

目的明确大鼠卵巢自体异位移植后的生存、生长及功能恢复情况。方法将性成熟的SD大鼠随机分为三组,A组为正常对照组,B组为去势对照组,C组为移植组。移植组将大鼠双侧卵巢自体移植于腹腔子宫角系膜处及颈部皮下,分别于移植后2、4、7、14、28、56d取移植的卵巢及部分子宫进行组织学研究,并取腹主动脉血测定血清雌激素、孕激素水平。结果移植卵巢依据苏木素-伊红(HE)染色后的组织学观察可分为三个阶段,移植后第2￣7天移植物内可见各期卵泡,数量少,多为原始卵泡及初级卵泡,有出血及炎细胞浸润,坏死区约占50%。第14天,移植物内可见不同阶段的发育卵泡,并可见间质腺及黄体,坏死区减少。第28天以后,移植物内可见大量不同阶段的发育卵泡,并可见间质腺及黄体,坏死区消失。移植组的子宫发育情况接近正常对照组,明显优于去势组。移植组平均第9天阴道涂片显示较规律的动情周期。血清学研究显示移植卵巢具有与正常卵巢接近的分泌雌激素、孕激素的功能。结论大鼠卵巢自体移植后能在异位存活,并可发育成具有内分泌功能的腺体,为卵巢组织移植治疗临床卵巢内分泌功能不足的可行性提供了实验依据。     

Soy but not bisphenol A (BPA) induces hallmarks of polycystic ovary syndrome (PCOS) and related metabolic co-morbidities in rats

Polycystic ovarian syndrome (PCOS) is the most common female endocrine disorder with a prevalence as high as 8–15% depending on ethnicity and the diagnostic criteria employed. The basic pathophysiology and mode of inheritance remain unclear, but environmental factors such as diet, stress and chemical exposures are thought to be contributory. Developmental exposure to endocrine disrupting compounds (EDCs) have been hypothesized to exacerbate risk, in part because PCOS hallmarks and associated metabolic co-morbidities can be reliably induced in animal models by perinatal androgen exposure. Here we show that lifetime exposure to a soy diet, containing endocrine active phytoestrogens, but not developmental exposure (gestational day 6–lactational day 40) to the endocrine disrupting monomer bisphenol A (BPA), can induce key features of PCOS in the rat; results which support the hypothesis that hormonally active diets may contribute to risk when consumed throughout gestation and post-natal life.     

多模态MRI对子宫恶性中胚叶混合瘤的影像学特征与病理对照的分析

目的探讨多模态MRI对子宫恶性中胚叶混合瘤(MMMT)的影像学特征与病理对照的关系,以提高对该病的认识及诊断准确率。方法选取28例经手术病理证实MMMT患者的临床资料,讨论分析临床特点、MRI平扫+联合动态增强(DCE-MRI)及弥散加权像成像DWI(ADC值)检查、病理学及免疫组化检查。结果MMMT癌成分为子宫内膜样腺癌12例,鳞状细胞癌及低分化浆液性腺癌8例,腺鳞癌伴鳞状分化6例,透明细胞腺癌2例;肉瘤成分为内膜间质肉瘤、平滑肌肉瘤、软骨肉瘤、纤维肉瘤、血管肉瘤、横纹肌肉瘤及成骨肉瘤;同源性为25例,以内膜间质肉瘤多见;异源性为3例,软骨肉瘤1例,横纹肌肉瘤及骨肉瘤2例。临床分期:Ⅰ期6例,Ⅱ期7例,Ⅲ期12例,Ⅳ期3例。28例MMMT的部位:原发病灶13例位于宫体内,8例位于宫底,3例位于宫颈,4例位于左侧卵巢。结论MMMT在MRI平扫+DCE-MRI及ADC值检查更能够清晰显示肿瘤的部位、范围、形态、大小、边界、信号特点及强化程度、弥散系数ADC值、淋巴结转移等情况,因此,结合临床特征、病理学及免疫组化检查为临床更进一步早期诊治、疗效评估及术前的准确诊断和制定合理的治疗计划提供更准确的参考依据,以提高患者生存率。     

Seasonal changes in plasma steroid levels in Indian major carp Labeo rohita: influence of homologous pituitary extract on steroid production and development of oocyte maturational competence

Circannual variations in plasma levels of testosterone (T), 17beta-estradiol (E(2)), and 17 alpha, 20 beta-dihydroxy-4-pregnen-3-one (DHP) as well as seasonal fluctuations in ovarian steroid synthetic potential were observed in Indian major carp, Labeo rohita. A study was also conducted to examine the mechanism of the development of gonadotropin-induced maturational competence in oocytes of this fish. The present study recorded the lowest values of plasma E(2) and T in L. rohita during the period from October to January. A mild increase in the levels of these steroids observed in February was followed by their rapid rise reaching peak values in April, when the ovary contained mostly the vitellogenic follicles. In the month of May, as the postvitellogenic follicles predominated in the ovary, there was a decline in plasma concentrations of both T and E(2). Low levels of these steroids in plasma remained until January, except a small elevation detectable during June and July (spawning stage). DHP was not detected in the plasma of this fish collected during the period from August to March. Existence of DHP was first recorded in blood in the month of April (vitellogenic stage) and it quickly reached the peak value in May (postvitellogenic stage), followed by a sudden decline in the month of June. Under stimulation of fish pituitary extract (FPE), as a source of gonadotropin, in vitro production of E(2) and T by the vitellogenic follicles was shown to be highest compared to their production rate in other stages, while the postvitellogenic follicles recorded the highest rate of DHP synthesis. Acquisition of oocyte maturational competence (OMC) was shown to develop either by priming the vitellogenic stage fish with a single dose of FPE or by in vitro addition of FPE in culture. In vitro treatment of trilostane, an inhibitor of 3beta-HSD, blocked the FPE-stimulated steroid production but not the development of OMC. Presence of cycloheximide and actinomycin D in the incubation was shown to inhibit FPE-induced development of OMC, indicating the requirement of de novo protein synthesis for this process.