调经固冲汤联合克罗米芬对多囊卵巢综合征的实验研究

目的:通过建立多囊卵巢综合征动物模型,观察调经固冲汤联合克罗米芬对PCOS的治疗提供实验依据。方法:采用俞瑾造模法建立PCOS大鼠动物模型,称重随机再分为模型对照组、克罗米芬组、调经固冲汤组、调经固冲汤联合克罗米芬组。结果:调经固冲汤联合克罗米芬能使PCOS大鼠血睾酮,LH、LH/FSH的比值、胰岛素下降。结论:说明调经固冲汤联合克罗米芬能够调节PCOS大鼠异常性激素和糖代谢。     

Incidental ovarian 18F-FDG accumulation on PET: correlation with the menstrual cycle

Purpose The aim of this study was to determine the nature of incidental ovarian ¹⁸F-fluoro-2-deoxyglucose (FDG) accumulation on positron emission tomography (PET) and the correlation with the menstrual cycle and menopause.Methods We identified 19 incidental FDG accumulations in the ovary (FAOs). FDG PET images were compared with other anatomical imaging methods [magnetic resonance imaging (MRI), computed tomography (CT) or ultrasonography (US)]. Pathological findings, FDG PET scan during the next menstrual cycle and follow-up images (PET, CT and MRI) were reviewed. To establish the relation of FAOs to the menstrual cycle, we reviewed whole-body FDG PET acquired from 207 consecutive women and the pre-examination questionnaires, including data regarding the menstrual cycle.Results All spherical or discoid FAOs were attributed to normally developing ovarian follicles and corpora lutea on the basis of concurrent MRI, US or the follow-up PET scan. Three of the FAOs were proved pathologically to be either normal ovaries or a haemorrhagic corpus luteum. Fifteen FAOs spontaneously disappeared on the short-term follow-up PET scans. Of 207 women, 61 had active menstrual cycles. FAOs were found in 12 out of 61 premenopausal women (20%), appearing between the 10th and 25th days of the menstrual cycle. No FAOs were found in the women who did not have a menstrual cycle.Conclusion Physiological ovarian FDG accumulation could be found around the time of ovulation and during the early luteal phase of the menstrual cycle in premenopausal woman. Since FAO is dependent on the menstrual cycle, it can be avoided by scheduling PET just after menstruation.     

Adnexal torsion

A series of 128 cases of adnexal torsion and an additional 97 cases where the preoperative diagnosis of torsion was incorrect are reviewed. The diagnosis is uncertain and surgical intervention is likely to be delayed. The adnexa are seldom salvaged despite the fact that torsion infrequently involves a malignant neoplasm. Laparoscopy is an effective means of reducing the number of necessary laparotomies when a diagnosis of torsion is uncertain.     

Morules with optically clear nuclei in ovarian borderline endometrioid tumor

Optically clear nuclei (OCN) have been observed in morules of some neoplasms and in some conditions unrelated to the development of the morules. We first report a case of ovarian borderline endometrioid tumor (BET) showing the morules associated with OCN. The patient was a 47-year-old premenopausal woman with a left ovarian cystic tumor, atypical endometrial hyperplasia, and elevated serum levels of FSH, LH, estradiol, and CA 125. The resected ovarian tumor measured 6 cm in diameter, and showed a papillary growth. Histologically, the ovarian tumor was consistent with BET, and the morules with OCN were scattered. Immunohistochemically, OCN were proven to be rich in biotin. An aberrant nuclear expression of beta-catenin was observed in both the tumor cells and the morular cells. Our case may suggest the possibility that the appearance of OCN with or without morules in ovarian tumors is related to endometrioid differentiation of the tumor cells, and should be recognized as a diagnostic clue of ovarian endometrioid tumors. Although female sex hormones have been reported to play a role in the occurrence of OCN, the participation of beta-catenin mutation has also been suggested.     

Ruptured Corpus Luteal Cyst: CT Findings

Objective

To evaluate the CT findings of ruptured corpus luteal cysts.

Materials and Methods

Six patients with a surgically proven ruptured corpus luteal cyst were included in this series. The prospective CT findings were retrospectively analyzed in terms of the size and shape of the cyst, the thickness and enhancement pattern of its wall, the attenuation of its contents, and peritoneal fluid.

Results

The mean diameter of the cysts was 2.8 (range, 1.5-4.8) cm; three were round and three were oval. The mean thickness of the cyst wall was 4.7 (range, 1-10) mm; in all six cases it showed strong enhancement, and in three was discontinuous. In five of six cases, the cystic contents showed high attenuation. Peritoneal fluid was present in all cases, and its attenuation was higher, especially around the uterus and adnexa, than that of urine present in the bladder.

Conclusion

In a woman in whom CT reveals the presence of an ovarian cyst with an enhancing rim and highly attenuated contents, as well as highly attenuated peritoneal fluid, a ruptured corpus luteal cyst should be suspected. Other possible evidence of this is focal interruption of the cyst wall and the presence of peritoneal fluid around the adnexa.     

降调节后激素预测体外受精周期中卵巢反应性

目的:探讨在体外受精周期中进行垂体降调节后的血清激素水平,预测不孕症患者卵巢的反应性,为选择最佳的超促排卵方案提供依据。方法:采用化学发光法,测定69例不孕症患者接受体外受精治疗周期中,应用促性腺激素释放激素激动剂进行垂体降调节前后月经第3天的血清卵泡刺激素和雌二醇水平,按卵巢反应性指标-获卵数及刺激程度,分为低反应组,正常反应组及过度刺激组,并作统计分析。结果:降调后月经第3天血清卵泡刺激素水平与获卵数呈显著负相关(r=-0.436,P=0.001)。基础卵泡刺激素水平与获卵数呈显著负相关(r=-0.334,P=0.005)。3组比较,年龄无差异性,获卵数、受精数均有显著性差异,P<0.05;促性腺激素总用量,低反应组与其他两组比较均有显著差异,P<0.05,而正常反应组与过度刺激组比较无差异性,P>0.05。降调后3组的妊娠结局无差异,P>0.05。结论:降调后月经第3天血清卵泡刺激素水平能较敏感地预测卵巢对促性腺激素刺激的反应性,优于基础血清卵泡刺激素水平的预测作用。     

多层螺旋CT重建技术在颌面部骨折的临床应用

目的探讨多层螺旋CT多平面重建（MPR）、容积重现（vR）和最大密度投影重建（MIV）在颌面部骨折中的临床应用价值。方法对96例颌面部创伤患者进行多层螺旋CT横断位容积扫描，常规层厚2mm，重建间隔1mm，螺距0．9mm,原始图像传输至工作站进行MPR、VR、MIP三维重建。结果三维重建影像显示骨折范围、位置、类型、骨折线走行方向及碎骨片移位等信息方面较轴位扫描图像有显著优势。结论多层螺旋CT三维重建技术的应用对颌面部骨折显示良好，有利于临床制定治疗方案。     

P53、Bcl-2、P16和c-myc在卵巢上皮性肿瘤中的表达及意义

 目的 研究P53、Bcl-2、P16和c－myc基因在卵巢上皮性肿瘤中的意义。方法 采用免疫组织化学法（SABC法）对80例良性、26例交界性和116例恶性卵巢上皮性肿瘤P53、Bcl-2、P16和c-myc癌基因的表达情况进行检测。结果 P53、Bcl-2、P16和c－myc表达率分别为36．48％、27．47％、83．33％和52．25％,P53、Bcl-2、c-myc表达随恶性程度增加而增高,良恶性之间表达差异有显著意义（P＜0．01）,P16随恶性程度增高表达率降低,恶性和良队间表达差异有显著性（P＜0．01）,恶性肿瘤中的P53\、Bcl-2和c－myc随分期增加,表达增加。结论 四种癌基因在卵巢上皮性肿瘤中高表达或表达失调,良恶性之间表达差异有显著意义,表明它们在卵巢上皮性肿瘤发生、发展中起重要作用。     

卵巢可能存在血-卵屏障——对家兔各级卵泡和毛细血管的形态学研究

作者应用血管注入追示剂的方法,在光、电镜下观察了30例家兔卵巢。研究结果:1.初步证明卵巢内存在屏障,命名为血—卵屏障;2.以生长卵泡和次级卵泡的屏障作用最为明显;3.排卵前后卵泡及闭锁卵泡的屏障作用有不同变化。并认为血—卵屏障是由①卵泡膜内层的毛细血管内皮;②内皮外方基膜;③卵泡基膜;④颗粒层细胞的“紧密”连接等四部组成。     

卵巢良恶性疾病上皮钙粘合素和α-连环素的表达及意义

本文通过ＡＢＣ免疫组化法研究Ｅ－Ｃａｄ、α－Ｃ在卵巢良恶性疾病组织中的表达及其生物学意义。结果表明卵巢浆液性腺瘤和绝大部分粘液性腺瘤（１２／１４）的Ｅ－Ｃａｄ、α－Ｃ表达明显地高于卵巢恶性肿瘤，与卵巢恶性肿瘤病理类型有一定关系，以浆液属于囊腺癌阳性表达率最高，而无性细胞瘤和颗粒细胞瘤均是阴性表达或表达下降；临床分析Ⅰ期、术后生存期〉１年及未转移病例Ｅ－Ｃａｄ、α－Ｃ阳性表达率均明显高于临床分期Ⅲ