Surgery: Adenomyosis at hysterectomy: a study on frequency distribution and patient characteristics

To evaluate the prevalence and risk factors for adenomyosis,the clinical records of consecutive women undergoing hysterectomyduring a 3 year period were retrieved. Data were collected onindication for the intervention, general sociodemographic characteristicsof the patients, age at menarche, parity, abortions, and menopausalstatus at surgery. Adenomyosis was diagnosed in 332 of the 1334cases (24.9%). The condition was present in 146 of the 627 patients(23.3%) with fibroids and menorrhagia, 68 of the 265 (25.7%)with prolapse, 21 of the 98 (21.4%) with ovarian cysts, 19 ofthe 100 (19%) with cervical cancer, 31 of the 110 (28.2%) withendometrial cancer, 16 of the 57 (28.1%) with ovarian cancer,and 19 of the 77 (24.7%) with miscellaneous indications. Thesedifferences were not statistically significant (x²₆ = 11.14).In comparison with nulliparous women, the odds ratio was 1.3and 1.5 respectively in women with one and two births (x²₁ trend= 5.76, P < 0.05). No relationship was found between ageat surgery, age at menarche, indications for surgery, menopausalstatus at intervention, and presence of endometriosis. Our findingsdo not support the notion that adenomyosis is more frequentlyrelated to particular clinical conditions, and suggest thatparity may be associated with an increased frequency of adenomyosis.     

共培养在小鼠胚胎发育过程中的作用

目的 通过人子宫内膜上皮与小鼠胚胎共培养,了解其对胚胎发育的影响。方法 观察共培养２４、３６ｈ及６０ｈ后的小鼠胚胎,并分级,结果 １共培养组停留于２细胞胚胎数显著少于对照组;２共培育２４、３６ｈ后,鼠胚１￣３有胚胎比例较对照组增加,差异有显著性;６０ｈ后,１￣３级胚胎比较与对照组相比差异无显著性。结论 人子宫内膜上皮与小鼠胚胎短期共培养有利于改善胚胎质量。     

子宫平滑肌肿瘤P16抑癌基因表达的定量研究与临床病理关系

目的 :为了探明抑癌基因 P16在子宫平滑肌瘤发生发展中的作用及其在诊断中的临床意义。方法 :应用细胞免疫荧光技术及流式细胞术 ,对 5 5例子宫平滑肌肿瘤石蜡组织块的 P16表达定量分析。结果 :正常子宫平滑肌组织 P16表达均为阴性。 14例平滑肌瘤仅 2例出现过度表达 (14 % ) ;交界性平滑肌肿瘤 12例 ;多数为过度表达 (75 % ) ;平滑肌肉瘤 2 9例中 ,则有 2 7例 (93 % )出现过度表达。从平滑肌瘤、交界性平滑肌瘤到平滑肌肉瘤 ,P16表达量显著递增。P16表达量随肿瘤细胞分裂相、异形性、密度的增高也有明显增高。P16低表达者 5年生存率为 85 % ,而过度表达者为 4 8.5 %。结论 :子宫平滑肌肿瘤一旦出现 P16过度表达应考虑为恶性 ;P16表达可能和平滑肌瘤向平滑肌肉瘤的转化密切相关 ,P16表达可作为判断病人预后的一项客观指标。     

氟尿苷在大鼠子宫组织内的分布及药动学研究

 目的研究氟尿苷(FUDR)在大鼠血清及子宫组织内的分布、代谢特征并进一步探讨FUDR与氟尿嘧啶(5FU)转化关系。方法建立了大鼠血清和子宫组织中FUDR及5FU的HPLC测定方法。130只雌性Wistar大鼠随机分组，尾静脉恒速输注FUDR或5FU，并按照设计的时间点断头放血，采集血及子宫组织标本，测定各标本中的FUDR及5FU浓度。考察FUDR在大鼠体内的动力学特征及其与5FU的转化关系，以及FUDR与5FU在大鼠子宫组织的分布特征。结果在本实验的剂量下，FUDR在大鼠体内呈现线性代谢特征，而其代谢物5FU则符合非线性特征。静脉输注时，5FU具有较强的血液/子宫组织穿透能力，其子宫组织5FU浓度(2.19～5.87) μg·g^-1与血液浓度(4.52～5.41) mg·L^-1相当。而输注FUDR时，子宫组织内的FUDR浓度很低，代谢物5FU的浓度(2.53～5.11)μg·g^-1却与输注5FU时的相当，而此时血清5FU浓度(0.47～0.83) mg·L^-1却远低于输注5FU时的血清浓度。结论FUDR具有更强的子宫组织亲和力，静脉输注FUDR后子宫组织内其代谢物5FU的浓度较高。     

葛根提取物对未成熟大鼠乳腺、子宫发育影响的研究

目的 :研究葛根提取物对大鼠乳腺、子宫发育的影响。方法 :正常Wistar雌性大鼠 4 0只 ,体重为 6 5～85g ,随机分为正常组、雌二醇组、葛根提取物低剂量组、葛根提取物高剂量组 ,每组 10只。各组给药 7d后 ,测血清中激素 ,剥离乳腺与子宫称重。结果 :①葛根提取物能显著提高未成熟大鼠乳腺和子宫重量 ;②葛根提取物能增加大鼠血清促卵泡生成素 (FSH)、促黄体生成素 (LH)、雌二醇 (E₂ )含量 ,降低泌乳素 (PRL)含量。结论 :葛根提取物能促进未成熟大鼠乳腺及子宫发育 ,为进一步开发促进青年女性乳腺及子宫发育的新药提供实验依据 ,同时为治疗先天性子宫发育不良患者提供基础资料。     

温经化瘀合剂药效学研究

目的：观察温经化瘀合剂(当归、川芎、香附、益母草等)治疗痛经、月经不调等作用。方法：对小鼠子宫、卵巢进行重量测定，二甲苯致小鼠耳肿胀法，缩宫素诱发大鼠痛经模型和前列腺素E1诱发小鼠痛经模型法，对大鼠离体子宫收缩活动的影响。结果：温经化瘀合剂能明显增加小鼠子宫重量，减轻二甲苯引起的小鼠耳肿胀度，减少缩宫素所致大鼠扭体反应次数和前列腺素E1所致小鼠扭体反应次数，既能使正常大鼠离体子宫收缩，又能对抗缩宫素对大鼠离体子宫的收缩作用。结论：温经化瘀合剂具有镇痛、抗炎作用，对子宫有双向调节作用。     

38例晚期产后出血的临床分析

目的:探讨引起晚期产后出血的临床原因。方法:对1998年-2002年间收治产后出血发生晚期出血的38例资料进行回顾性分析。结果:38例中在基层乡镇医院分娩者占68.4％,在市级医院分娩者占31.6％。结论:晚期产后出血的主要原因是胎盘胎膜残留和子宫切口愈合不良。     

The change in tenascin expression in mouse uterus during early pregnancy

Purpose: Our aim was to examine the changes in spatiotemporal tenascin (TN) expression in mouse uterus during early pregnancy, when the uterine tissue undergoes a tremendous restructuring. Methods: Using immunohistochemistry and in situ hybridization, the changes in distribution of TN protein in mouse uterine tissues in pregnancy Day 0 through Day 5 were analyzed. Results: Immunoreactive TN and TN mRNA were expressed in the basement membrane of the epithelium as well as in the smooth muscle layer, and their distribution shifted from the subbasement region on Day 0–3 to the smooth muscle layer on Days 4 and 5. Conclusions: These results indicate that TN expression in the uterus during early pregnancy is spatiotemporally different and may be regulated by a different mechanism.     

Pelvic ultrasonography in normal girls and in girls with pubertal precocity

This prospective study sought to evaluate the role of pelvic ultrasonography in differentiating between various types of pubertal precocity. A control group of 117 normal girls (aged 1.1-15.6) was studied and compared with 87 girls with premature sexual maturation (aged 1.1-9.2y). Of these patients 19 had central precocious puberty (CPP), 48 had isolated premature thelarche (IPT) and 20 had premature adrenarche (IPA) Pelvic ultrasound variables evaluated were: (i) uterus: longitudinal diameter (uterine length), cross-sectional area (CSA) and fundo-cervical ratio; and (ii) ovaries: volume and morphology. Ovarian morphology was subdivided in 6 different appearances: solid, microcystic, paucicystic, multicystic, macrocystic, and major isolated cyst. In normal control girls, uterine length and CSA increased with age, although no cut-off values could be defined between different age ranges, and they were correlated with breast stage; fundo-cervical ratio was stable through childhood and increased after age 9. Ovarian volume was significantly greater in pubertal girls with breast stage 2 than in those with only pubic and/or axillary hair. There was a clear predominance of solid ovarian appearances in the age range 2-7, with the multicystic appearance being seen only after age 7, a minority being macrocystic. After age 10 all the different patterns were observed, and after age 13 the frequency of a macrocystic pattern increased. Significantly more mature ovarian appearances were observed in subjects with breast development compared with those without, independently of the presence of pubic hair. Patients with IPT had no significant differences in pelvic ultrasound measurements when compared with age-matched controls. All the different morphological ovarian appearances were observed in IPT, in contrast to age-matched controls, where only the less mature patterns (solid, micro- and paucicystic) were seen. Patients with CPP had significantly more mature patterns of ovarian morphology compared with age-matched controls, but did not differ from pubertal pre-menarcheal controls. Those patients with IPA differed from age-matched controls only in having significantly greater uterine length and CSA. Comparison of the pelvic ultrasound parameters between patient groups (IPT, CPP, IPA) and age-matched controls revealed significantly higher values in CPP for uterine length, uterine CSA and ovarian volume. Ovarian volume was also greater in IPT than in IPA. Ovarian morphology was significantly different in patients (IPT, CPP, IPA) compared with age-matched controls, but none of the ovarian morphological appearances was exclusive to a single condition. In conclusion: (i) pelvic ultrasound parameters increase progressively from birth to maturity, but no clear cut-off values can be established between age ranges; (ii) pelvic ultrasound variables reach adult values during puberty, with differences in the timing that may reflect geographical variations; (iii) the multicystic ovarian appearance occurs just before the onset of puberty; (iv) pelvic ultrasonography cannot always differentiate clearly between different disturbances of puberty and therefore cannot supersede other observations and investigations in the evaluation of pubertal disorders; and (v) in this study we propose a more detailed pelvic ultrasound terminology that can avoid apparent confusion in defining ovarian ultrasound appearance.