超声彩色脉搏波技术在定量评价2型糖尿病患者颈动脉弹性变化中的应用

目的 探讨超声彩色脉搏波(UFPWV)技术在定量评价2型糖尿病患者颈动脉血管管壁弹性变化中的应用价值。方法 回顾性研究。纳入2018年7月-2019年3月蚌埠医学院第一附属医院收治的97例2型糖尿病患者为观察组,其中男47例、女50例,年龄20~74(46.6±9.3)岁;根据颈动脉内中膜厚度(IMT)将观察组分为颈动脉粥样斑块组(A组)、颈动脉内中膜增厚组(B组)和颈动脉内中膜正常组(C组),依据下肢动脉有无斑块将C组分为下肢动脉斑块组(C1组)、下肢动脉无斑块组(C2组)。选取2017年12月-2018年12月在蚌埠医学院第一附属医院体检中心血糖及颈动脉IMT正常的健康体检者64人为对照组,其中男25人、女39人,年龄20~74(44.3±12.0)岁。运用UFPWV采集脉搏波速度 (PWV),计算颈动脉收缩早期PWV(PWV-BS)及收缩晚期PWV(PWV-ES),分析各项参数组间的差异。结果 观察组中,A组颈动脉PWV-BS、PWV-ES分别为(9.51±1.25)m/s、(10.79±1.64)m/s,B组分别为(8.47±0.91)m/s、(9.81±1.05)m/s,C组分别为(7.97±0.77)m/s、(9.07±0.74)m/s,对照组颈动脉PWV-BS、PWV-ES分别为(6.10±1.00)m/s、(7.40±1.20)m/s,A组、B组、C组及对照组间颈动脉PWV-BS、PWV-ES测量值依次降低,差异均有统计学意义(P值均<0.05)。C组中,C1组颈动脉PWV-BS、PWV-ES分别为(7.83±0.85)m/s、(8.82±0.59)m/s,C2组分别为(8.14±0.64)m/s、(9.34±0.79)m/s, C1组PWV-ES显著高于C2组,差异有统计学意义(t=3.402,P＜0.01),而两组间PWV-BS的差异无统计学意义(P>0.05)。结论 UFPWV技术可定量评价2型糖尿病患者颈动脉弹性变化,并可通过PWV-ES的改变评估颈动脉形态学正常的患者动脉粥样硬化的进展程度,对临床诊疗具有一定意义。     

Secretory role for human uterodomes (pinopods): secretion of LIF

The differentiation of human endometrial epithelium is a dynamic event, which occurs throughout the menstrual cycle in preparation for pregnancy. The appearance of uterodomes (pinopods) in this regard was first introduced in rodents with an established pinocytotic function, whereas little evidence was available in humans in this context. This study was undertaken to identify the potential physiological roles of uterodomes in the implantation process. To address this, endometrial biopsies from early, mid- and late luteal phases of the menstrual cycle of 23 fertile female patients with regular menses were used. Scanning and transmission electron microscopies (SEM and TEM) as well as immunofluorescence and immunogold TEM were performed to study the morphological changes and the expression pattern of leukaemia inhibitory factor (LIF) at uterodomes. Our results illustrated a high level of LIF expression in the human uterodomes, which was colocalized with the well-known biochemical markers of exocytosis, including syntaxin-1, 25-kDa synaptosomal protein (SNAP-25) and vesicle-associated membrane protein-2 (VAMP-2). Our morphological and immunocytochemical findings illustrated a secretory function for human uterodomes for the first time. In conclusion, this novel function for uterodomes provides an important clue in detection of their physiological function(s) during the process of the plasma membrane transformation.     

PAI-1基因多态性与不孕患者子宫内膜发育不良的遗传易感性研究

目的 探讨纤溶酶原激活剂抑制物-1(plasminogen activator inhibitor-1,PAI-1)基因多态性与不孕患者的子宫内膜发育的相关性.方法 选取经B超测量子宫内膜厚度及子宫内膜病理学检查诊断为子宫内膜发育不良不孕患者105例,有正常生育的健康非妊娠妇女85名,应用聚合酶链反应-限制性片段长度多态性分析技术检测PAI-1基因-675位4G/5G多态性.结果 患者组PAI-1基因4G/4G基因频率(48.6%)和4G等位基因频率(66.2%)显著高于对照组(22.4%和47.1%)(P<0.01)差异有统计学意义,与5G/5G基因型比较4G/4G型患者发生子宫内膜反应不良致不孕的相对风险率的比数比(odds ratio,OR)为4.9,95%的可信区间为2.10-10.12.结论 PAI-1基因4G/5G多态性与不孕患者的子宫内膜发育不良密切相关.     

肺耐药蛋白在子宫内膜癌中表达及其临床意义

目的 探讨肺耐药蛋白(LRP)在子宫内膜癌治疗中的作用及预后关系。方法 采用免疫组化染色SP法，检测30例石蜡包埋的子宫内膜癌中LRP的表达，并对应用化疗后的效果进行分析。结果 (1)LRP阳性表达率80％(24／30)；(2)LRP表达阳性者的化疗有效率约为45．8％，明显低于LRP表达阴性者(83．3％)；(3)LRP的表达与腹水相关，与患者年龄、临床分期、组织分级无关；(4)LRP表达阴性患者预后明显优于阳性。结论 LRP是评价子宫内膜癌化疗耐药性和预后可靠指标。     

Expression of Intercellular Adhesion Molecule-1 (ICAM-1) on Cultured Human Endometrial Stromal Cells and Its Role in the Interaction With Natural Killers

PROBLEM: Recent evidence emphasizes the role of natural killer cells (NKs) as potential effectors of peritoneal immune surveillance directed against the outgrowth of endometrial cells, refluxed with menstrual debris, in ectopic sites. This NK-mediated cytotoxicity toward autologous endometrial antigens seems to be significantly decreased in endometriosis patients. METHOD: We set up experiments to clarify which molecules are involved in NK-endome-trial cell interaction. In particular, we evaluated the surface expression and functional activity of intercellular adhesion molecule-1 (ICAM-1), a cell surface glycoprotein that has been identified as one of the ligands for lymphocyte function-associated antigen-1 (LFA-1), present on almost all leucocyte cell types. Immunofluorescence flow cytometry was used to assess ICAM-1 expression on resting and IL 1β-activated endometrial stromal cells in culture. Dermal fibroblasts were used as control cells. Cytotoxicity and binding assays by ⁵¹Cr release in presence and absence of a specific monoclonal antibody (mAb) against ICAM-1 were then performed in order to determine the effect of this molecule on NK-mediated cytotoxic and binding activity toward endometrial stromal cells. RESULTS: The results of this study indicated that ICAM-1 expression on endometrial stromal cells seems to be constitutively higher than on dermal fibroblasts and can be up-regulated upon exposure to IL 1β. Furthermore, a mAb against ICAM-1 strongly inhibits the binding but not the cytotoxicity of NKs toward endometrial cells. No difference in the expression of this molecule was observed throughout the cycle. CONCLUSIONS: The presence of ICAM-1 on human endometrium might relate to the action of the immunocompetent cells in human specific reproductive events.     

The measurement of CA 125 and placental protein 14 in uterine flushings in women with recurrent miscarriage; relation to endometrial morphology

The concentrations of CA 125 and placental protein 14 (PP14)were measured in uterine flushings obtained throughout the lutealphase of the cycle from eight normal fertile women. The concentrationsof both proteins increased in a similar pattern throughout theluteal phase of the cycle, with the most dramatic increase occurring6 days after their luteinizing hormone surge (day LH +6). However,a greater variation in CA 125 concentrations was seen comparedto that seen for PP14. The concentrations were compared to thoseobtained on day LH + 7 of the cycle from a group (n equals;35) of women with recurrent miscarriage. The ranges in concentrationof PP14 and CA 125 in the flushings of fertile and recurrentmiscarriage patients were very similar. However, a greater proportionof women with recurrent miscarriage (55%) had low concentrations(<5 ng/ml) of PP14 than in the control group (12.5%) andthe concentrations of PP14 in the uterine flushings were significantlyless (P < 0.05) in women with recurrent miscarriage comparedto the normal fertile group. There was no significant differencein the concentrationof CA 125 in the uterine flushings betweenthe two groups. Histological observation of the endometrialbiopsy samples from recurrent miscarriage patients gave menstrualcycle datings that ranged from day LH +2.5 to LH +6.5 with retardedendometrium (;day LH +5) in 12 of 35 (34%) patients. Of these12 patients, 10 (83%) had low PP14 concentrations and six (50%)had low CA 125 concentrations in their uterine flushings. Inthe recurrent miscarriage patients with histologically normal(sequals; day LH +5) endometrial development, 10 out of 23 (43%)also had low PP14 concentrations and 8 out of 23 (35%) had lowCA 125 in their uterine flushings. The results suggest thatPP14 is better than CA 125 as a marker for endometrial functionin this group of women. In some cases (52%) the low concentrationsof PP14 in the uterine flushings couldbe explained by retardedendometrial development but for the others the reduction inPP14 concentration in the uterine flushing was not associatedwith retardation of endometrial development.     

Differences in diazepam pharmacokinetics in Chinese and white Caucasians – Relation to body lipid stores

Summary We have compared diazepam pharmacokinetics in 16 Chinese and 18 white Caucasian healthy male volunteers, resident in Hong Kong and have correlated them with physical attributes. Serum concentrations of diazepam and desmethyldiazepam were measured in venous blood by an enzyme-linked immunoassay (0–3 h samples) and HPLC (3–72 h samples). Pharmacokinetic parameters were derived assuming a two compartment model, distribution phase <6 h, and 100% oral systemic availability. Compared with the Chinese the white Caucasians were older, heavier, taller, and fatter, as judged by skin fold thickness (SFT) and total body weight to Ideal body weight (TBW/IBW) ratio; respective mean differences being 16%, 27%, 4%, 26%, and 15% (p<0.05). Mean diazepam apparent volume of distribution (V) and V/IBW were larger in the white Caucasians (52% & 39% respectively, p=0.002). SFT and TBW/IBW ratio yielded the best correlations with V, V/TBW and V/IBW (0.50–0.75, p<0.05). Obesity indices contributed most to the overall regressions (R² up to 0.52), and for V there was a further small effect (2%, partial F test) due to ethnic group, possibly reflecting stature. Mean peak diazepam concentration (C_max) was similar in both ethnic groups. Time to C_max (t_max) was more often prolonged in the Chinese (X ² test, p=0.01). Body fat and stature may thus account for these inter-ethnic differences in the apparent volume of distribution of diazepam, a highly lipid-soluble drug.     

磁共振成像对前置胎盘的临床诊断价值

目的：探究磁共振成像（MRI）对前置胎盘的诊断价值。方法：选取2018年1月至2021年6月新疆生产建设兵团医院接诊的基于临床症状诊断为前置胎盘孕妇79例,所有孕妇均在手术前行盆腔MRI扫描,观察胎盘厚度、宫颈长度、胎盘T2低信号带、宫颈边缘窦、膀胱隆起、子宫肌层变薄信号,分析上述MRI征象、指标对前置胎盘的诊断价值。结果：79例孕妇中,最终经手术病理证实为前置胎盘的患者52例。MRI征象中的胎盘T2低信号带、宫颈边缘窦、膀胱隆起、子宫肌层变薄均可有效诊断前置胎盘（P <0.05）;检出率由高到低依次为：胎盘T2低信号带>宫颈边缘窦>子宫肌层变薄>膀胱隆起;胎盘厚度≥10 mm时,胎盘厚度与前置胎盘呈正相关（r=0.852,P=0.016）;胎盘厚度<10 mm时,胎盘厚度与前置胎盘无相关性（r=0.201,P=0.052）。宫颈长度≥30 mm时,宫颈长度与前置胎盘无相关性（r=0.376,P=0.071）;宫颈长度<30 mm时,宫颈长度与前置胎盘呈负相关（r=–0.721,P=0.036）。结论：MRI征象（胎盘T2低信号带、宫颈边缘窦、膀胱隆...     

子宫内膜癌创伤后成长水平及影响因素分析

目的探讨子宫内膜癌创伤后成长水平及影响因素,以期为提高该类患者创伤后成长水平提供指导依据。方法选取2017年9月至2019年11月贺州市人民医院收治的子宫内膜癌患者168例作为研究对象,对其一般资料、领悟社会支持、创伤后成长情况进行调查统计。使用单因素和多重线性回归分析其中影响因素。结果患者的创伤后成长水平总分为(60.19±15.30)分,其中个人力量(12.08±3.02)分,欣赏生活(11.26±3.10)分,精神变化(9.66±3.02)分,与他人关系(13.05±3.03)分,新的可能性(14.14±3.60)分。单因素分析显示,文化程度、婚姻状况、家庭人均月收入、医疗费用支付情况、肿瘤组织分化程度、病理分期及领悟社会支持量表(Perceived Social Support Scale,PSSS)评分可能是子宫内膜癌患者创伤后成长水平的影响因素(P<0.05)。多重线性回归分析结果显示,文化程度、婚姻状况、家庭人均月收入、医疗费用支付情况、肿瘤组织分化程度、病理分期及PSSS评分均进入回归方程。结论经历癌症创伤事件后,子宫内膜癌患者会出现一定程度的创伤后成长,其创伤后成长水平处中上水平。文化程度、婚姻状况、经济状况、癌症分化与分期及领悟社会支持状态是子宫内膜癌患者创伤后成长水平的主要影响因素。临床需加强对低学历者的健康宣教,提高其疾病认知水平,注重中晚期患者的心理干预,对于低收入患者相关部门可制定更加人性化且合理的医疗费用支付和补助政策,同时充分发挥患者的家庭内及家庭外支持系统。     

输卵管通液术与子宫内膜异位症的关系

目的：探讨输久管通液术与子宫内膜异位症的关系。方法：直视下对104例输卵管性不孕患地输卵管通液术,收集输卵管流出液作巴氏染色进行宫内膜细胞的检查。结果：发现子宫内膜异位症29例（27．88％）,检出宫内膜细胞60．67％（63／104）,对月经周期中不同时间通液进行比较,发现各时间段宫内膜细胞的检出率之间差异无显性意义（P＞0．05）。结论：通液术将宫内膜细胞带入盆腔可能是造成子宫内膜异位症的原因,但不同时间通水宫内膜细胞的检出无显差异。