Central pontine myelinolysis: sequele of hyponatremia during transcervical resection of endometrium

Transcervical resection of endometrium is an alternative to hysterectomy for women with menorrhagia. The procedure involves the use of cutting loop diathermy to resect the endometrium while the uterine cavity is irrigated with 1.5% glycine which can absorb consequent fluid and electrolyte shifts. Severe hyponatremia leading to central pontine myelinolysis is an extremely rare complication of this procedure. We report a case of a young female undergoing transcervical resection of endometrium for menorrhagia, who developed central pontine myelinolysis but made a complete recovery after three months.     

阴道B超在辅助生育技术中的应用

阴道B超是辅助生殖医学中主要的辅助检查技术,常用于自然周期或促排卵周期中监测卵泡生长情况,评价子宫内膜状态,指导促排卵药的合理使用,降低相关并发症如:卵巢过度刺激、多胎妊娠等的发病率.现将阴道B超在辅助生育技术中的应用作以综述.     

FHIT expression in neoplastic, hyperplastic, and normal endometrium

Fragile histidine triad (FHIT), a candidate of tumor suppressor protein, expression was examined on paraffin-embedded specimens in proliferative, secretory, hyperplastic, and neoplastic human endometrium by immunohistochemistry. The results of FHIT immunoreactivity in endometrial carcinomas were compared with prognostic indicators as well as with p53 overexpression. Forty-four cases of endometrial carcinoma, 30 normal functional (15 proliferative, 15 secretory), and 24 hyperplastic endometrium (12 without atypia, 12 with atypia) specimens were studied using polyclonal FHIT antibody. The streptavidin-biotin-peroxidase detection system was used, and the intensity and the distribution of immunoreactivity were evaluated semiquantitatively. There were no significant differences in FHIT expression in the proliferative, secretory, hyperplastic, either with or without atypia, or carcinomatous endometria. No significant difference in FHIT expression of endometrial carcinomas was detected when prognostic parameters or p53 overexpression were considered. Loss or reduced FHIT expression was not found to predict disease-free or cumulative survivals. This study showed that loss or reduction in FHIT protein expression is present in normal functional and hyperplastic endometria as well as in neoplastic endometrium. FHIT protein seems not to be involved directly in endometrial carcinogenesis, but rather, it regulates cell proliferation both in physiologic and in pathologic conditions of endometrium.     

细胞间粘附分子-1在子宫内膜异位症在位内膜、腹腔液及异位灶中的表达及分析

目的:探讨ICAM 1与子宫内膜异位症的关系。方法:收集子宫内膜异位症患者(研究组)腹腔液30份、在位子宫内膜2 1份、异位病灶组织8份及非子宫内膜异位症患者中正常盆腔(对照组)腹腔液2 5份、子宫内膜2 0份。应用酶联免疫吸附试验双抗体夹心法测定腹腔液sICAM 1和免疫组化方法测定在位内膜、异位灶内膜ICAM 1表达。结果:子宫内膜异位症患者腹腔液中sICAM 1水平明显高于对照组(P <0 .0 1 ) ,子宫内膜的ICAM 1表达低于对照组同期子宫内膜的表达(P <0 .0 5 ) ,异位灶组织ICAM 1表达明显高于其在位内膜(P <0 .0 1 )及对照组内膜(P <0 .0 5 )。结论:子宫内膜异位症患者子宫内膜、腹腔液、异位灶内膜细胞间粘附分子的异常表达可能与子宫内膜异位症的发生发展关系密切。     

CuIUD对妇女子宫内膜环氧化酶表达的影响

目的:　研究置固定式铜宫内节育器(FCuIUD)前后妇女子宫内膜组织中环氧化酶(COX-1、COX-2)的表达。方法:　选择符合受试条件的育龄妇女10 例,于月经净后3-7　d放置FCuIUD,置器前及置器后一个月于相同时期、相同部位刮取子宫内膜。RT-PCR法与Western　blot法分析放置FCu-IUD前后妇女子宫内膜组织COX-1、COX-2　mRNA及蛋白表达水平。免疫组化S-P法测定COX-2在子宫内膜的定位与分布。结果:置FCuIUD一个月后,子宫内膜COX-2　mRNA和蛋白表达水平均显著增加,与置器前比较,差异显著(P<0.05)。COX-1　mRNA及蛋白的表达在置器前后无明显差异。COX-2主要分布于腺上皮细胞的胞浆内。结论:　置FCuIUD后妇女子宫内膜COX-2表达在转录和翻译水平均显著增加;COX-2可能是节育器引起的无菌性炎症中PGs释放增加的主要同工酶。     

围排卵期应用左炔诺孕酮对着床期子宫内膜整合素表达的影响

目的:研究合成孕激素左炔诺孕酮对子宫内膜着床期整合素亚单位表达的影响。方法:20名妇女,随机分为两组,在LH-2日(LH-2组)或LH+2日(LH+2组)服用左炔诺孕酮0.75 mg/次,bid。每组妇女在服药周期前一个周期于LH-2日或LH+2日服用安慰剂,作为对照周期。两组均以超声波和尿LH峰检测确定服药日。每一周期均于LH+7日取子宫内膜标本。用整合素亚单位a1、a4、avb3抗体,以免疫组化和计算机图象分析方法检测和评价这些亚单位的表达。结果:两组在服用左炔诺酮后亚单位a1染色强度降低,但avb3无变化。亚单位a4在LH-2组明显降低,在LH+2组则差别不明显,而两组集合也是明显降低的。结论:妇女紧急避孕应用左炔诺酮后,其子宫内膜整合素亚单位a1和a4的表达与甾体激素的调控密切相关,有关机理尚需进一步研究。     

子宫内膜异位症在位内膜及裸鼠模型异位病灶芳香化酶的表达及意义

目的:探讨芳香化酶在子宫内膜异位症(EMs)在位内膜及其裸鼠模型异位病灶中的表达意义。方法:征集EMs组及非异位症(NEMs)组各24例,应用其分泌晚期子宫内膜,建立EMs裸鼠模型,取建模后5d、15d、30d裸鼠异位病灶,RT-PCR及免疫组化方法检测两组在位内膜和异位病灶芳香化酶mRNA及蛋白表达。结果:芳香化酶mRNA表达,EMs组异位病灶(0.894±0.23)表达强于在位内膜(0.685±0.15),P<0.05;阳性表达率(87.50%,83.33%)无差异。NEMs组异位病灶表达强度和阳性表达率(0.920±0.24,95.83%)均高于在位内膜(0.612±0.15,62.50%),P<0.05。两组在位内膜比较,EMs组阳性表达率高于NEMs组,P<0.05。两组异位病灶及各组不同时期异位病灶(EMs组,5d:0.889±0.23;15d:0.990±0.19;30d:0.880±0.29;NEMs组,5d:0.889±0.23;15d:0.905±0.23;30d:0.918±0.22)比较,芳香化酶mRNA表达无差异。芳香化酶蛋白阳性表达率,EMs组异位病灶(95.83%)与在位内膜(91.67%)比较,差异不显著。NEMs组异位病灶(95.83%)高于在位内膜(70.83%),P<0.05。EMs组在位内膜高于NEMs组,P<0.05;两组异位病灶比较,差异不显著。结论:局部雌激素合成增强在EMs发病机理中起重要作用。芳香化酶是EMs等雌激素依赖性疾病在子宫内膜特异性表达标记物。     

环氧合酶-2在子宫内膜异位症子宫内膜组织中的表达

目的：研究环氧合酶-2（COX-2）在子宫内膜异位症（内异症）在位子宫内膜组织和异位子宫内膜组织中的表达及意义。方法：采用免疫组织化学方法检测30例卵巢内异症在位内膜、10例卵巢巧克力囊肿壁异位内膜及27例正常子宫内膜中COX-2的分布和表达。结果：COX-2在3组子宫内膜腺上皮细胞和间质细胞中均可见表达。COX-2在正常对照组内膜和卵巢内异症组在位内膜腺上皮细胞中的表达均是分泌期高于增生期（P<0.05)，而在间质细胞中的表达分泌期与增生期比较无统计学差异（P>0.05)。COX-2在卵巢内异症组在位和异位内膜中的表达均高于对照组（P<0.05），而内异症患者在位和异位内膜中COX-2的表达则无统计学意义（P>0.05）。结论：COX-2在卵巢内异症在位和异位内膜中表达增高，可能与卵巢内异症的病理异常有关。     

Expression of Nuclear Factor-Kappa-B in Mouse Enometrium Treated with Different Levels of Estridiol or Progesterone

Objective To investigate the effect of estridiol nuclear factor-kappa-B （NF-kB） expression in and progesterone at different levels on mouse endometrium Methods Ovarioectmized mice were randomly divided into 9 groups, i.e. groups of sham operation, of estridiol only, of progesterone only and of progesterone combined with estridiol. Mice in the experimental groups accepted subcutaneous injections of estridiol or progesterone at different levels for one week. Their uteri were collected to detect the expression of NF-kB by immunohistochemical assay. Results Estridiol at a daily dose of 30 μg/kg and 100 μg/kg could significantly stimulate the expression of NF-kB in mouse endometrium（P〈0.01）, but not in an obvious dose-dependent fashion （P〉0.05）. Progesterone alone could inhibit the expression of NF-kB in cytoplasma （P〈0.01）. Combination of estridiol and progesterone could increase NF-kB expression both in cytoplasma and nuclear （P〈0.01）. Conclusion Eestridiol can up-regulate the expression of NF-kB in mouse endometrium, while progesterone exhibits down-regulation effect. This finding suggests that estridiol and progesterone might modulate the endometrium receptivity by affecting NF-kB pathway.     

Expression of TRAIL in Mouse Uterine Endometrium during Embryo Implantation

Tumor necrosis factor (TNF), which is primarily produced from activated macrophages, is one of the important cytokines that can induce cells to undergo apoptosis[1]. TNF-relatedapoptosis-inducing ligand (TRAIL), also called Apo-2L, is a new member of TNF …