保留食道心脏薄层解剖断面和正常近端冠状动脉多平面TEE显像的对照研究

目的 :为冠状动脉的多平面 TEE显像提供连续的薄层断面解剖学基础 ,确定近端冠状动脉在多平面 TEE中的最佳显示方位和层面。方法 :用冰冻薄层断面技术将 2 4个保留食道的心脏标本制作成与人体横断面成 0°、 45°、 90°、 1 35°四个方位的薄层连续解剖断面 ,观察和分析近端冠状动脉的走行 ;并与 30个健康成人的心脏多平面 TEE进行对照研究 ,确定 TEE显示近端冠状动脉的最佳方位和层面。结果 :0°、 45°方位的心脏薄层断面和多平面 TEE切面能清晰地显示左右冠状动脉主干和左冠状动脉分叉 ,90°、1 35°方位能显示左右冠状动脉的起始部。结论 :保留食道心脏薄层断面解剖学研究能够为冠状动脉的多平面 TEE显像提供解剖学基础     

不孕症妇女支原体感染与抗精子抗体、抗子宫内膜抗体的相关性研究

【目的】探讨不孕症妇女生殖道解脲支原体（UU）感染与血清抗精子抗体（AsAb）、抗子宫内膜抗体（AEMAb）产生的关系。【方法】使用Roche LightCycle荧光定量PCR检测仪对374例女性不孕患者宫颈粘液进行UU检测，同时对其血清的AsAb和AEMAb采用酶学免疫法（ELISA）进行检测。对UU、AsAb和UU、AEMAb均为阳性组均予强的松治疗3个月；两组随机分为加用抗生素组和不用抗生素组，比较两组的疗效。【结果】374例不孕症患者中，UU阳性组AsAb检出率为45．2％，UU阴性组AsAb检出率为23．7％，两组之间差异有显著性（P〈0．05）；UU阳性组AEMAb检出率为38．4％，UU阴性组AEMAb检出率为18．0％，两组之间差异有显著性（P〈0．05）。抗体转阴率为64．9％，未使用抗生素组抗体转阴率为31．0％，两组疗效差异有显著性（P〈0．05）；UU、AEMAb均为阳性组加用抗生素组抗体转阴率为56．7％，未使用抗生素组抗体转阴率为42．3％，两组比较使用抗生素组抗体转阴率较高，但差异无显著性（P〉0．05）【结论】生殖道感染UU与AsAb和AEMAb的产生有密切的关系，可能引起女性免疫性不孕。积极治疗生殖道感染有助于降低抗体滴度，阻止抗体形成，对免疫性不孕的治疗有重要意义。     

刺五加叶中金丝桃苷的薄层鉴别和含量测定

目的：以金丝桃苷为指标成分,建立刺五加叶的薄层定性和含量测定的方法。方法：采用薄层色谱法对刺五加叶中金丝桃苷进行定性鉴别,并用高效液相色谱法进行含量测定,色谱柱：Kromasil 100-5C18色谱柱（4.6mm×250mm）;流动相：甲醇-0.1％冰醋酸水溶液(35：65);流速：0.8mL/min;检测波长：360nm;柱温：30℃;进样量：10μL。结果：刺五加叶金丝桃苷的薄层鉴别特征明显,金丝桃苷在0.13～0.78μg范围内具有良好线性关系,r=0.9994,平均回收率为98.17％,RSD为1.02％（n=5）。结论：此方法简便、快速、准确,可用于刺五加叶的质量控制。     

趋化因子在子宫内膜异位症患者中的表达及临床意义

目的：探讨调节活化正常T细胞表达与分泌的趋化因子( RANTES)在子宫内膜异位症患者血清、在位/异位内膜组织中的表达水平及临床意义。方法选择确诊为盆腔子宫内膜异位症的患者89例为研究对象(观察组),以武汉市江夏区第一人民医院妇产科同期取宫内节育器且盆腔结构正常的60例女性为对照组,收集所有患者临床资料。采用酶联免疫吸附( ELISA)法检测血清、异位/在位内膜RANTES水平,并进行分析。结果观察组血清RANTES水平显著高于对照组(t=3.06,P<0.05),且观察组中Ⅰ~Ⅱ期、Ⅲ~Ⅳ期血清RANTES水平均显著高于对照组(t值分别为2.68、4.13,均P<0.05)。在位内膜组和异位内膜组RANTES水平均较正常内膜组显著升高(t值分别为3.26、4.05,均P<0.05);Ⅰ~Ⅱ期、Ⅲ~Ⅳ期异位内膜组RANTES水平均较Ⅰ~Ⅱ期、Ⅲ~Ⅳ期在位内膜组显著升高(t值分别为3.15、4.23,均P<0.05)。子宫内膜异位症血清RANTES水平与盆腔粘连范围评分呈显著正相关(r=3.986,P<0.05),与痛经评分无显著相关性(r=0.287,P>0.05)。结论 RANTES可能在子宫内膜异位症的发生发展中起重要作用。     

Pathology of the endometrium in women with chronic hepatitis C and HIV infection as a cause of unsuccessful in vitro fertilization attempts

Abstract

Aim: The purpose of the study is to detect endometrial pathology in individuals with blood-borne infections (hepatitis C virus [HCV] and HIV) and to assess the impact of quality of the endometrium on the efficiency of assisted reproductive technologies (ART).

Materials and methods of research: The study involved 56 women of reproductive age, 33 women with HCV, 22 with HIV infection (stages 3 and 4A) and 1 patient with co-infection of HCV and HIV, which was excluded from the further study. Ultrasound investigation of the small pelvic organs, hysteroscopy with biopsy of the mucosa of the uterine cavity, histological examination of the endometrium, determination of HCV RNA and HIV RNA in serum and endometrial tissue by PCR method were conducted.

Results: Ultrasound and histological studies of the endometrium revealed a high incidence of development of hyperplastic and inflammatory processes of the endometrium in women with HCV (86% and 100%) and HIV (51% and 99%). When molecular biological examination of endometrial tissue of these patients was performed with the use of a set of reagents “AmpliSens HCV/HBV/HIV-FL” produced by Federal Budgetary Institution of Science (FBUN) Central Research Institute of Epidemiology of Rospotrebnadzor of Russia, HCV was detected in 16.7% and HIV in 14.3% of cases. In 5% of patients with HCV infection and 7% with HIV, pathogens were detected in the endometrium under the non-detectable viral load in the blood plasma. Lower effectiveness of IVF in women with HIV and HCV is defined compared to the women without blood-borne infections.

Conclusion: Detected HIV and HCV replications in the endometrium is the likely cause of hyperplastic and inflammatory processes of the endometrium leading to reduced efficiency of the ART programs in patients with chronic hepatitis C and HIV.