当归补血汤对去势大鼠血清SOD、MDA含量和脾脏、子宫指数的影响

目的:研究当归补血汤对去势大鼠血清超氧化物歧化酶(SOD)、丙二醛(MDA)含量和脾脏、子宫指数的影响。方法:实验分为5组,即假手术、模型、六味地黄丸和当归补血汤高、低浓度组。将3月龄SD未孕雌性大鼠给予单侧切除卵巢造模,酶联免疫法测定大鼠血清SOD、MDA含量和脾脏、子宫指数。结果:与模型组比较,当归补血汤高、低浓度和六味地黄丸组血清MDA含量均显著降低(P<0.01),血清SOD活性和脾脏、子宫指数均显著升高(P<0.01)。结论:当归补血汤抗衰老和增强抵抗力的内在机制之一可能与提高清除自由基能力以及增加免疫器官重量有关,高浓度当归补血汤作用更为明显。     

介入治疗在难治性产后出血中的应用

目的探讨介入导管动脉栓塞术（Transcatheter Arterial Embolization,TAE）治疗难治性产后出血的临床效果。方法对11例患者采用Sedinger技术行双髂内动脉插管,造影确认后注入明胶海绵颗粒阻断血供,行子宫动脉栓塞或髂内动脉栓塞。结果11例患者均获得有效止血,无一例复发,并保留了子宫和卵巢生理功能。结论介入导管动脉栓塞术治疗难治性产后大出血具有止血迅速,疗效可靠,创伤小,并发症少等特点,不仅能挽救产妇的生命,而且能保留子宫,值得推广应用。     

先天性阴道斜隔综合征临床特征及影像学诊断价值的初步研究

目的探讨先天性阴道斜隔综合征（OVSS）临床特征及影像学诊断价值。 方法回顾性分析2017年1月至2022年4月在北京协和医院手术的102例OVSS患者的临床及影像资料,以手术及病理结果为诊断标准,总结分析不同类型OVSS的临床特征及超声和MRI诊断结果。 结果102例OVSS患者中,Ⅰ型30例,Ⅱ型43例,Ⅲ型15例,Ⅳ型14例。Ⅰ型的发病年龄及初潮至发病时间间隔均显著小于其他3种类型（P均＜0.05）。痛经及腹痛在Ⅰ型（83.33%）及Ⅳ型（100.00%）的发生率明显高于Ⅱ型（44.19%）及Ⅲ型（40.00%）,差异均有统计学意义（P均＜0.05）。月经淋漓不尽在Ⅲ型（46.67%）的发生率明显高于Ⅰ型（10.00%）及Ⅳ型（0）,差异均有统计学意义（P均＜0.05）。阴道脓性分泌物在Ⅱ型（25.58%）的发生率明显高于Ⅰ型（0）,差异有统计学意义（P＜0.05）。右侧阴道斜隔56例（56/102,54.90%）,均合并右肾缺如（54.90%）;左侧阴道斜隔46例（46/102,45.1%）,伴有左肾缺如43例（42.16%）,左肾发育不良1例（0.98%）。102例患者均进行了超声检查,超声正确诊断双子宫双宫颈92例,正确诊断完全型纵隔子宫7例,超声诊断与手术符合率为97.06%（99/102）。82例进行了MRI检查,MRI正确诊断双子宫72例,正确诊断完全型纵隔子宫5例,MRI诊断与手术符合率为93.90%（77/82）。所有102例均进行了阴道斜隔切除术治疗,其中55.88%（57/102）进行了腹腔镜探查联合阴道斜隔切除术,19.61%（20/102）切除患侧子宫。Ⅳ型卵巢子宫内膜异位囊肿的发生率显著高于Ⅰ型及Ⅱ型（P均＜0.05）。Ⅳ型采用的腹腔镜探查联合阴道斜隔切除术及患侧子宫切除术明显多于其他3型（P均＜0.05）。 结论不同分型的OVSS临床特征有所不同,超声与MRI均可较好地早期诊断OVSS及其并发症,为手术方案的选择提供重要信息。     

磁共振成像在妊娠期子宫嵌顿诊治中的应用探讨

目的: 探讨磁共振成像（magnetic resonance imaging,MRI）在妊娠期子宫嵌顿诊治中的应用价值。方法: 回顾性分析2010—2020年于北京大学第三医院产科诊治的4例妊娠期子宫嵌顿病例,回顾MRI和超声检查对该病例诊断的经验和术前评估的价值。结果: 2例初次超声提示完全性前置胎盘,2例超声提示宫颈及子宫下段回声杂乱,4例经MRI检查后明确诊断妊娠期子宫嵌顿,其中1例孕中期复位后自然分娩,1例因为合并胎盘植入孕中期终止妊娠,2例于孕晚期结合MRI图像制定围术期方案,母儿结局良好。结论：MRI 能够对疑似妊娠期子宫嵌顿的病例进行明确诊断,同时可以指导制定手术方案。超声疑似子宫嵌顿病例应及时完善MRI明确诊断,有助于改善母儿结局。     

Anthropomorphic phantoms for assessment of strain imaging methods involving saline-infused sonohysterography

Two anthropomorphic uterine phantoms were developed that allow assessment and comparison of strain imaging systems adapted for use with saline-infused sonohysterography (SIS). Tissue-mimicking (TM) materials consist of dispersions of safflower oil in gelatin. TM fibroids are stiffer than the TM myometrium/cervix, and TM polyps are softer. The first uterine phantom has 3-mm-diameter TM fibroids distributed randomly in TM myometrium. The second uterine phantom has a 5-mm and 8-mm spherical TM fibroid, in addition to a 5-mm spherical and a 12.5-mm-long (medicine capsule-shaped) TM endometrial polyp protruding into the endometrial cavity; also, a 10-mm spherical TM fibroid projects from the serosal surface. Strain images using the first phantom show the stiffer 3-mm TM fibroids in the myometrium. Results from the second uterine phantom show that, as expected, parts of inclusions projecting into the uterine cavity will appear very stiff, whether they are stiff or soft. Results from both phantoms show that although there is a five-fold difference in the Young's moduli values, there is not a significant difference in the strain in the transition from the TM myometrium to the TM fat. These phantoms allow for realistic comparison and evolution of SIS strain imaging techniques and can aid clinical personnel to develop skills for SIS strain imaging.     

腹式全子宫切除术新术式的探讨

目的:探讨腹式全子宫切除术采用新术式有何优点。方法:回顾性分析我院从1997年1月～1999年10月收治患子宫良性病变160例患者,且具有手术指征行腹式全子宫切除术进行随机对比分析。其中80例采用新术式,80例采用传统式,两组进行比较。结果:采用新术式①手术时间平均缩短24min,P<0.001;②出血量平均减少50mL,P<0.001;③出院时间早2—3d。结论:采用新术式可缩短手术时间,减少出血量,住院时间短,且增强盆腔脏器的固定作用及盆底的支持力,术后不会发生阴道壁松驰及脱垂,阴道长度术后无明显改变,不影响术后性生活。     

Histologic and morphologic effects of valproic acid and oxcarbazepine on rat uterine and ovarian cells

Purpose:   To determine the histologic and morphologic effects of valproic acid (VPA) and oxcarbazepine (OXC) on rat uterine and ovarian cells.
Methods:   Fifty-six female prepubertal Wistar rats (21–24 days old and weighing between 47.5 and 58.1 g) were divided equally into four groups, which were given drinking water (controls), 300 mg/kg/day of VPA, 100 mg/kg/day of OXC or VPA + OXC via gavage, for 90 days. Ovaries and uteri of rats on proestrous and diestrous phases of estrous cycle were extirpated and placed in a fixation solution. The tissue specimens were assessed with apoptosis (TUNEL) staining protocols, eosinophil counting, and electron microscopic techniques.
Results:   In uteri, apoptosis in stroma, mitochondrial swelling, and cristolysis were observed in the VPA group, and OXC led to negative effects on epithelial cell and intracellular edema. In ovaries, both drugs increased apoptosis and intracytoplasmic edema. Organelle structure disruption was also observed in the OXC group. More conspicuous degenerative modifications were determined in the VPA + OXC group. In uteri, the number of TUNEL-positive luminal epithelial cells was 7.20 ± 1.32 in controls, and significantly increased to 29.60 ± 1.58, 34.20 ± 2.53, and 54.80 ± 2.04 in VPA, OXC, and VPA + OXC groups, respectively (p < 0.001). The highest number of TUNEL-positive glandular epithelium cells was observed in the VPA + OXC group; however, the number of TUNEL-positive stroma cells was highest in the VPA group. The highest number of eosinophils in stroma was in the VPA group.
Conclusion:   VPA and OXC trigger apoptotic and degenerative effects on rat uterine and ovarian cells. VPA also prevents implantation of embryo to the uterus and causes abortion via endometrial eosinophil infiltration.     

超声监测在宫腔镜电切术治疗子宫纵隔中的应用

目的：探讨B型超声监测在宫腔镜电切术治疗子宫纵隔中的应用价值。方法：1999年1月～2007年10月，对136例经宫腔镜联合B超检查发现的纵隔子宫实施宫腔镜纵隔电切手术。术中B超全程监护。术后随访1～60个月。结果：136例患者手术均顺利完成，元1例子宫穿孔，109例有生育要求者，83例（76．1％）妊娠，其中52例已足月分娩。结论：B型超声术中全程监护对宫腔镜电切术手术具有导向作用，可提高手术的安全性和成功率。     

Different proliferative responses of Gi/o-protein-coupled receptors in human myometrial smooth muscle cells

The majority of studies investigating the proliferative effect of G_i/o-protein-coupled receptor agonists are performed in recombinant receptor systems or cell lines. In these systems the relative stoichiometry of receptors compared to other cell components might be changed, which may lead to anomalies in cellular responses in contrast to natural occurring systems. In the present study, we have used primary cultures of smooth muscle cells (SMCs) isolated from human myometrium to characterize the proliferative effects of agonists binding to two different G protein-coupled receptors. Treatment of quiescent SMCs with lysophosphatidic acid (LPA) and noradrenaline resulted in significant increases in [³H]thymidine incorporation. However, LPA was almost four times more effective than noradrenaline in this respect. The proliferative effects of the agonists could be completely blocked by pertussis toxin, indicating that the response are mediated through G_i/o-proteins. The selective α₂-adrenergic receptor (α₂-AR) antagonist yohimbine dose-dependently reduced the effect of noradrenaline suggesting that the proliferative response was mediated through α₂-ARs. The proliferative effects induced by LPA and noradrenaline was markedly reduced in SMCs treated with the tyrosine kinase inhibitor genistein and the cAMP elevating compound forskolin. However, LPA but not noradrenaline induced rapid rises in the cytosolic free Ca²⁺ concentration [Ca²⁺]_i. The ability to increase Ca²⁺ might be one explanation why LPA produce a more pronounced proliferative response than noradrenaline in primary cultures of human myometrial SMCs.     

Langzyklus

Zusammenfassung Die konventionelle zyklische Anwendung oraler Kontrazeptiva adaptiert sich an den spontanen Menstruationszyklen, indem regelmäßige Entzugsblutungen hervorgerufen werden. Die regelmäßigen Entzugsblutungen können durch eine Langzyklusanwendung kontinuierlich kombinierter Ovulationshemmer über einen Zeitraum von 3–6 Monaten oder länger vermieden werden. Dadurch wird die Menstruationsfrequenz gesenkt, und zyklusabhängige Beschwerden werden gemindert. Auch wenn insbesondere in den ersten Einnahmewochen irreguläre Blutungen auftreten können, so haben Studien doch gezeigt, dass Langzyklen von vielen Frauen bevorzugt werden. Durch das fehlende einnahmefreie Intervall wird die kontrazeptive Sicherheit bei Langzyklen erhöht. Durch die Vermeidung von Abbruchblutungen werden Störungen — wie Hypermenorrhö, Dysmenorrhö, aber auch Endometriose, Uterusmyome — effektiv therapeutisch beeinflusst.