国内首例子宫原发性原始神经外胚叶肿瘤报告并文献复习

迄今国外文献仅报道16例子宫原发性原始神经外胚叶肿瘤(pPNET),本文在国内首次报道1例经手术病理检查确诊的子宫原发性原始神经外胚叶肿瘤。患者因经期延长、经量增多3个月入院,入院后经相关检查诊断为子宫肌瘤并中度贫血,后经多次输注浓缩红细胞,血红蛋白升至85.9 g/L后,在全麻下行子宫肌瘤剜除术,术后病理检查诊断为子宫前壁下段PNET,转入妇科肿瘤病房,行子宫全切、右侧附件切除并盆腔淋巴结清扫术。术后诊断子宫前壁下段pPNETⅠb期,予化疗。随访2.5年无复发。本文通过对本例临床资料进行回顾性分析并复习相关文献,探讨pPNET相关特点及诊治情况,以提高临床医生对pPNET的认识。     

缺氧对滋养细胞E-钙黏蛋白表达的影响

目的:了解在缺氧条件下,单层贴壁培养的滋养细胞系TEV-1中,E-钙黏蛋白(E-cadherin,E-cad)的表达在mRNA水平和蛋白水平变化情况,探讨缺氧环境对滋养细胞迁移能力的影响,深入了解缺氧环境诱发子痫前期发病的潜在分子机制。方法:体外贴壁培养的滋养细胞系(TEV-1),分别直接接种于24孔板进行细胞爬片和培养瓶内,分为常氧组和缺氧组。常氧组加新鲜DMEM/F12培养基,缺氧组加含终浓度为300μmol/L二氯化钴的培养基,然后在正常条件下(37℃,5%CO2)培养。两组细胞培养48 h后,分别收集细胞,采用Trizol法抽提mRNA,并进行RT-PCR,检测E-钙黏蛋白的mRNA表达水平;细胞爬片采用免疫组织化学法进行染色,检测E-钙黏蛋白的蛋白表达水平。统计数据分析两组差异性。结果:二氯化钴化学缺氧条件下培养后,滋养细胞E-钙黏蛋白的mRNA和蛋白表达水平均较常氧对照组升高,差异具有统计学意义(P<0.05)。结论:缺氧环境可能导致滋养细胞E-钙黏蛋白的mRNA和蛋白的表达水平升高,由此降低了滋养细胞的迁移能力。这可能是缺氧造成胎盘浅着床、继而发生子痫前期的重要分子机制。     

不同浓度VEGF对AECII表达SP-B和TGF-β1的影响及意义

目的探讨血管内皮生长因子（vascular endothelial growth factor,VEGF）对肺泡II型细胞（type 2 alveolar epi-thelial cell,AECⅡ）表面活性蛋白-B（surfactant associated protein,SP-B）和转化生长因子-β1（transforming growth fac-tor beta-1,TGF-β1）表达的影响及意义。方法原代培养早产鼠AECII,采用real-time RT-PCR、细胞免疫染色等方法,观察VEGF对AECII SP-B及TGF-β1表达的影响。结果 Real-time PCR结果显示25ng/ml VEGF组与正常组相比SP-B mRNA表达水平明显上升（P〈0.05）。25ng/ml VEGF组与正常组相比TGF-β1 mRNA表达明显下降（P〈0.05）,其他各组与正常组相比无统计学差异（P〉0.05）。结论 VEGF在适宜浓度时有促进SP-B表达的作用,同时有抑制TGF-β1表达的作用,推测VEGF促进SP-B表达的作用与直接或间接抑制TGF-β1的表达有关。     

武汉地区252例高危孕妇染色体核型分析

随着科技不断进步与发展,羊水细胞培养及染色体核型分析技术已经成为临床上最常用且安全可靠的产前诊断方法,被广泛应用于诊断胎儿染色体病及胎儿畸形。羊膜腔穿刺(羊水细胞分析)通常在孕16-18w进行,可以进行核型分析(细胞遗传学和分子遗传学方法);先天性肾上腺增生、囊性纤维化等DNA分析;生化研究如怀疑神经管畸形时检查     

Implication of Expression of Osteopontin and Its Receptor Integrin αvβ3 in the Placenta in the Development of Preeclampsia

To investigate the expression of osteopontin （OPN） and its receptor integrin αvβ3 in the placental tissue from pregnant women complicated with preeclampsia, the expression of OPN and αvβ3 in the placenta of the pregnant women with preeclampsia and healthy pregnant women was detected by immunohistochemistry, Western blotting and RT-PCR. Our results showed that OPN and αvβ3 protein were expressed in the placenta from normal pregnant woman and those with preeclampsia. OPN was located in the placental syncytiotrophoblasts and the cytoplasm of capillary endothelial cells and integrin αvβ3 was mainly expressed on the surface of trophoblast cells. Expression of OPN and integrin αvβ3 in the placental tissue from preeclampsia subjects was significantly lower than that from the control group （P〈0.05）. Compared with the control group, expression of OPN in the placental tissue from preeclampsia group was significantly lower （P〈0.05） but there was no significant difference in the expression of αv and β3 between the preeclampsia group and the controls. It is concluded that OPN and its receptor integrin αvβ3 may be involved in the pathogenesis of preeclampsia.     

妇产科常见疾病与染色体核型异常的关系分析

目的 分析染色体核型异常与妇产科常见疾病的关系，探讨流产、死胎、畸胎、不孕、月经不调及青春期发育异常的遗传病因。方法 532例病例，每例行外周血培养，细胞收获，制片及G显带，并行染色体核型分析。结果 532个病例中，共检出异常核型25例，检出率为4．7％，其中异常孕产史和不孕16例，占64％，月经不调和发育异常7例，占28％，其它2例，占8％。结论 染色体核型异常是导致流产、死胎、畸胎及不孕的重要原因之一；染色体核型异常与月经不调、青少年发育异常有密切关系。     

Effects of maternal serum on permeability of glomerular endothelial cell membrane

The mechanism of injury on the human glomerular endothelial cells(ciGENC) induced by preeclampsia serum was investigated.Concentration of maternal serum sFlt-1 protein was detected by ELISA.Fluorescently-labeled bovine serum albumin infiltrating through lower chamber of Transwell was measured by multifunction microplate reader.Morphologic change of ciGENC was observed under inverted phase contrast microscope.The concentration of sflt-1 in preeclampsia groups was significantly increased as compared with control group(P<0.01).Permeability in preeclampsia groups was significantly increased as compared with control group(P<0.01).By contrast with severe preeclampsia group,the permeability of ciGENC monolayer in mild preeclampsia group was decreased significantly(P<0.05).Intervention of exogenous VEGF significantly decreased permeability of ciGENC in preeclampsia groups.It was concluded that sFlt-1 increased ciGENC permeability by damaging integrity of endothelial barrier function.     

双胎妊娠一胎死亡后期待治疗14例分析

目的:探讨双胎妊娠孕中晚期一胎死亡后期待治疗的临床效果。方法:回顾性研究分析1994年1月至2004年4月同济医院双胎妊娠一胎死亡的病例共14例。结果:期待治疗时间最长为61天,最短为3小时,平均保胎时间为12天,分娩平均孕周为32周。无一例出现明显凝血功能障碍。先兆子痫和胎膜早破发生率最高(35.7%)。胎儿畸型是胎死宫内的重要原因。结论:双胎妊娠一胎死亡后可采取期待治疗,在严密监测存活胎儿宫内安危,积极处理母体合并症或并发症的条件下,尽量延长存活胎儿在宫内生长的时间,提高存活胎儿的生存质量。     

蛋氨酸合成酶还原酶基因A66G多态性与Down综合征发生的相关研究

目的:研究蛋氨酸合成酶还原酶(MTRR)基因A66G多态性与Down综合征的关系。方法:采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)法对32例DS患儿母亲及70例未生育DS患儿女性MTRR的A66G进行基因分析。比较上述各组基因型和等位基因频率分布有无差异。结果:MTRR基因A66G突变型等位基因G频率在实验组和对照组中有显著性差异,GG基因型频率分布差异有显著性(P<0·05)。AG基因型比AA基因型生育DS患儿风险高1·98倍,GG基因型比AA基因型生育DS患儿风险高5·2倍。结论:MTRR A66G基因多态性与Down综合征发生相关,AG、GG基因型增加了Down综合征的发生风险。     

重度子痫前期患者脐静脉血清中VEGF及sFlt-1的表达及其对内皮细胞损伤的影响

目的 探讨重度子痫前期患者脐静脉血清中血管内皮生长因子(vascular endothelial growth factor,VEGF)和可溶性血管内皮生长因子受体1(soluble fms-like tyrosine kinase receptor 1,sFlt-1)表达的特点,及其对内皮细胞损伤的影响.方法 采用ELISA试剂盒定量检测10例正常妊娠及10例重度子痫前期患者脐静脉血清中sFlt-1及VEGF的蛋白表达水平.分别将两组血清在体外干预人脐静脉内皮细胞株(EVC-304)生长,利用:①荧光标记的牛血清白蛋白检测内皮细胞的单层屏障功能;②MTT法检测内皮细胞的增殖能力;③硝酸还原酶法检测内皮细胞的一氧化氮合成能力;以评估两组血清对内皮细胞功能的影响.结果 ①与正常妊娠组相比,重度子痫前期组患者脐静脉血清中sFlt-1蛋白水平明显升高;而游离VEGF蛋白水平明显降低,两者呈负相关.②与正常妊娠组相比,重度子痫前期组脐静脉血清可使内皮细胞功能明显受损,包括:(1)通过单层内皮细胞的牛血清白蛋白浓度升高,即内皮细胞的单层屏障功能受损;(2)内皮细胞增殖能力明显被抑制;(3)培养液中NO浓度明显降低.③内皮细胞功能损伤程度与重度子痫前期组脐静脉血清中sFlt-1/VEGF水平成正相关.结论 子痫前期患者血清中sFlt-1和VEGF表达失衡,与子痫前期内皮细胞损伤密切相关,可能是参与子痫前期发生发展的重要机制之一.