子宫内膜癌发病相关因素的分析

目的 研究子宫内膜癌的发病年龄、临床表现及病理特点.方法 对41例子宫内膜癌患者回顾性分析,分为2组,A组:年龄小于49岁的11例,B组:年龄大于50岁的30例.结果 A组深肌层浸润率为9%,B组为33.33%.A组肿瘤细胞分化程度好于B组,淋巴结转移率及手术范围小于B组.结论 病人年龄、肿瘤肌层浸润深度、淋巴结转移是子宫内膜癌预后的重要影响因素.     

Epithelial–mesenchymal transition in carcinomas of the female genital tract

Invasion is a defining feature of malignancy, but the mechanisms of invasion in many common cancers, including gynaecological malignancies, remain unclear. However, it has been proposed that malignant cells may usurp a normal embryological process, epithelial–mesenchymal transition (EMT), as a means of acquiring migratory capacity. The synergistic role of the tumour microenvironment in EMT induction has also been explored and helps to explain the spatially restricted distribution of EMT at the deep tumour margin (invasive front). Furthermore, tumour cells undergoing EMT may acquire cancer stem cell characteristics, and this may be relevant to the entire metastatic process and to tumour recurrence and treatment failure. Nevertheless, doubts persist regarding the role of EMT in malignant progression in vivo, partly because few studies have correlated molecular and histological alterations in clinical pathology specimens. In the current review we summarize the evidence for EMT in the common gynaecological epithelial malignancies, and discuss the morphological and immunohistochemical changes occurring at the invasive tumour front that may represent EMT‐like processes. The possibility that carcinosarcomas represent a variant type of EMT with ‘fixed’ mesenchymal differentiation is also considered. Diagnostic histopathologists are ideally placed to critically evaluate the role of EMT in gynaecological and other types of malignancy.     

Role of 3D sonohysterography in the investigation of uterine synechiae/asherman's syndrome: Pictorial assay

Several imaging methods have been applied for evaluation of suspected uterine synechiae; however, sonohysterography is yet recognised as a valid and accurate modality. Performing three‐dimensional (3D) imaging along with sonohysterography enables evaluation of the uterus in the coronal plane to detect and grade the adhesions that characterise this condition. Thus, 3D sonohysterography is a minimally invasive and cost‐effective tool for investigating suspected synechiae and is particularly useful when the transvaginal sonography findings are normal.     

Pharmacodynamics of combined estrogen–progestin oral contraceptives: 4. Effects on uterine and cervical epithelia

ABSTRACT

Introduction: Steroid hormones are responsible for specific changes in the endometrium during the menstrual cycle, when they are sequentially secreted and, because of this, in the early days sequential combined oral contraceptive regimens were utilized. The same basic concept has been utilized with multi-phasic regimens, in order to produce endometrial pictures mimicking the normal cycle.

Areas covered: The Endometrial effects of progestins and estrogens; combined monophasic high- (50 μg), medium- (30 μg), low- (20 μg), ultralow- (15 μg) estrogen content; sequential regimens; multiphasic combinations; treatment schedules.

Cervical effects of combined high-dose and sequential combinations, including evidence for an increase in malignant lesions.

Expert opinion: Overall, combined oral contraceptives (COCs) inhibit normal proliferative changes and the endometrium becomes thin, narrow, with widely spaced glands and pre-decidual changes in the stroma. During the first few cycles the progestin induces a coexistence of proliferative and secretory features; with time, the picture changes because the progestin induces a down-regulation of estrogen receptors, resulting in tortuous glands similar to those in the secretory phase, but characterized by a quiescent, atrophic glandular epithelium.

In the cervical epithelium, under the influence of high-dose COCs, endocervical glands became hypersecretory and in some instances, distinctive type of atypical polypoid endocervical hyperplasia is found.     

Activation cross-sections of proton induced reactions on natural Ni up to 65 MeV

Production cross-sections of the ^natNi(p,x)^60,61Cu, ^56,57Ni, ^55,56,57,58Co nuclear reactions were measured in five experiments up to 65 MeV by using a stacked foil activation technique. The results were compared with the available literature values, predictions of the nuclear reaction model codes ALICE-IPPE, TALYS-1.4, and extracted data from the TENDL-2012 library. Spline fits were made on the basis of selected data, from which physical yields were calculated and compared with the literature values. The applicability of the ^natNi(p,x)⁵⁷Ni, ⁵⁷Co reactions for thin layer activation (TLA) was investigated. The production rate for ⁵⁵Co was compared for proton and deuteron induced reactions on Ni.     

一贯煎联合薄芝糖肽、羟氯喹治疗干燥综合征合并血小板减少性紫癜血小板恢复正常1例报告

报告1例使用一贯煎联合薄芝糖肽、羟氯喹治疗干燥综合征合并血小板减少性紫癜血小板恢复正常。女,22岁;口干眼干,腮腺反复肿大,伴关节窜痛3年;PLT 18×109/L↓,MPV 16.2fL↑;IgA 3.47g/L↑,IgG 19.59g/L↑,IgM 1.41g/L↑,RF 404.8IU/mL↑,抗核抗体(ANA)(+),核颗粒型1:1000(++),抗SSA抗体(+),抗SSB抗体(-),抗Ro-52抗体(+)。一贯煎(黄芪、女贞子各20g,灵芝10g,生地30g,沙参15g,麦冬10g,枸杞子、当归各15g,白芍、石斛、郁金各10g,杜仲、菟丝子各20g,丹皮10g,川楝子15g,酸枣仁10g),1剂/d,水煎400mL,早晚口服;薄芝糖肽10mg/次,1次/d,静滴;羟氯喹,0.2g/d,2次/d,口服。连续治疗7.5月复查:PLT 136×109/L;口眼干涩症状缓解,无新发出血点。     

育胞养膜颗粒联合芬吗通对肾阳虚薄型子宫内膜的影响

目的观察育胞养膜颗粒联合芬吗通对肾阳虚薄型子宫内膜的影响。方法选取2015年6月～2017年6月在我院中医科就诊的肾阳虚薄型子宫内膜不孕患者62例,随机分为研究组与对照组,各31例,研究组芬吗通阴道上药同时口服育胞养膜颗粒,对照组芬吗通阴道上药同时口服阿司匹林。治疗3个月,比较两组子宫内膜厚度、卵泡发育情况、妊娠率和不良反应发生率。结果与各自治疗前比较,治疗后两组子宫内膜厚度均增加,差异有统计学意义(P0.05),两组成熟卵泡平均直径均增加,研究组治疗前后差异显著(P0.05),对照组治疗前后无显著差异(P0.05);治疗后组间比较,研究组子宫内膜厚度、成熟卵泡平均直径均大于对照组(P0.05),研究组宫内妊娠率高于对照组(P0.05)。两组均未发生明显不良反应。结论育胞养膜颗粒联合芬吗通可有效改善子宫内膜厚度和卵泡发育情况,提高妊娠率,疗效优于芬吗通联合阿司匹林。