孕三烯酮对大鼠血清雌孕激素及在位和异位子宫内膜雌孕激素受体的影响

目的:探讨孕三烯酮(gestrinone)治疗子宫内膜异位症的作用机理。方法:用自体移植术建立大鼠子宫内膜异位症动物模型,随机分组给药,3周后剖腹,取血测定雌二醇(E2)、孕酮(P)浓度,取出子宫及移植物,固定、切片,免疫组化SP法测定各组动物子宫及移植物的雌激素受体(ER)和孕激素受体(PR)的表达。结果:孕三烯酮高剂量使大鼠血清E2、P水平降低,而中低剂量对E2、P水平影响不大。免疫组化结果则显示移植物的ER、PR含量较子宫内膜低,孕三烯酮高、中剂量可下调在位和异位子宫内膜ER、PR表达,而低剂量孕三烯酮则不能明显改变ER、PR的表达量。结论:孕三烯酮可通过降低体内雌孕激素水平以及下调在位及异位子宫内膜ER、PR的表达,发挥对子宫内膜异位症的治疗作用。     

Absorption of 17 beta-estradiol in a neovagina constructed from the peritoneum

Estrogen absorption from the neovagina was studied by administering 2.0 mg of micronized 17 beta-estradiol (E2) neovaginally to 6 patients. The neovagina in each patient was constructed by using the peritoneum from the pouch of Douglas. A mean peak of circulating E2 concentrations more than 15-times the basal level was achieved 90 min after the application. Until 12.5 h after the application, the E2 levels were significantly (P less than 10(-6)) elevated. FSH levels were significantly (P = 0.003) changed in comparison to the basal serum concentration. There was no significant (P = 0.08) change in LH levels. The resorption of estradiol from the neovagina is similar to that seen in women with normal vaginas.     

临产前后子宫平滑肌组织中G蛋白偶联受体30的表达及其临床意义研究

目的 探讨G蛋白偶联受体30（GPR30） mRNA和蛋白在临产前、后子宫平滑肌组织中的表达及其与分娩发动的相关性。方法 2011年3月至2012年3月在青岛市市立医院选取临产前进行选择性剖宫产的足月妊娠妇女作为未临产组（n=40）,自然临产进入产程活跃期后进行急症剖宫产的足月妊娠妇女作为临产组（n=50）,于剖宫产术中取少量子宫平滑肌组织,采用实时荧光定量PCR技术和Western blot技术检测两组子宫平滑肌组织中GPR30 mRNA和蛋白的表达量;并于术前取静脉血,采用放射免疫法测定血清中雌二醇（E2）、雌三醇（E3）以及孕酮（P）的含量。结果 实时荧光定量PCR方法检测临产组和未临产组子宫平滑肌组织中均有GPR30 mRNA表达,临产组样本△Ct为3.08±0.35,未临产组样本△Ct为4.02±0.67,差异具有统计学意义（P＜0.05）,用双△Ct法进行相对定量分析,临产组GPR30 mRNA表达量是未临产组的1.92倍。Western blot技术检测临产组和未临产组子宫平滑肌组织中均有GPR30蛋白表达,临产组GPR30蛋白相对表达量4.06±0.25明显高于未临产组1.94±0.23,差异有统计学意义(P＜0.05)。临产组血清E2、E3浓度[（7882.41±921.76）pmol/L,（544.12±15.58）nmol/L]均显著高于未临产组[（5210.72±873.13）pmol/L,（326.36±12.26）nmol/L]。结论 足月妊娠分娩发动时GPR30高表达可能参与介导雌激素对子宫收缩的调节作用。     

Breast cancer and sex steroids: Critical review of epidemiological,experimental and clinical investigations on etiopathogenesis,chemoprevention and endocrine treatment of breast cancer

There is strong epidemiological, experimental and clinical evidence that the etiology of breast cancer is closely related to long-term exposure of breast epithelium to sex steroid hormones. Estrogens can enhance the development of breast cancer by stimulating cell proliferation rate and thereby increasing the number of errors occurring during DNA replication, as well as by causing DNAdamage via their genotoxic metabolites produced during oxidation reactions. Anti-estrogenic drugs, including tamoxifen, raloxifene and anastrozole, have been tested with promising results in the chemoprevention of breast cancer in high-risk women. As for the use of exogenous sex-steroids in the gynecological practice, data about breast cancer risk associated with oral contraception are reassuring, and available data on oral hormone replacement therapy (HRT) use for not more than 5 years have failed to detect a significant increase in the risk of developing a breast cancer. Long-term HRT administration increases the incidence of this tumor slightly, with a relative risk ranging from 1 to 2 depending on hormone preparation. Estrogens alone, even if taken for long periods of time, seem to be safer than estrogen/progestin combinations. New administration routes and novel hormone regimens are currently under evaluation,.and these new HRT modalities could have different impact on breast cancer risk because of their metabolic and pharmacodynamic effects.     

雌激素受体亚型mRNA在子宫内膜癌组织中的表达

目的比较雌激素受体两种亚型α和β在子宫内膜癌中的表达,探讨雌激素受体亚型在子宫内膜癌发生和发展中的作用.方法用RT - PCR法检测子宫内膜癌和正常子宫内膜组织雌激素受体mRNA的表达.结果①与正常子宫内膜组织比较,子宫内膜癌中ER α mRNA、ER β mRNA表达和ER β/ER α mRNA比值都明显上升;②早期、内膜样子宫内膜癌ER α mRNA明显上升.结论子宫内膜癌的发生与ER α和ER β的表达有关,ER α mRNA表达升高可能提示子宫内膜癌预后较好.     

The effect of estradiol on human myelomonocytic cells. 1. Enhancement of colony formation

Cyclic changes were observed in the content of blood monocytes during the menstrual cycle of normal women. Elevated blood monocytes were found during the ovulation period as well as in other conditions which are associated with increased blood estradiol (E2). To understand the possible association between E2 and monocytosis, we analysed the in vitro effect of E2 on the development of myelomonocytic colonies in culture. E2 in physiological concentrations was found to increase the number of colonies developed from peripheral blood mononuclear cells (PBM) of both females and males. The optimal concentration for the augmenting effect on males' PBM was lower than that for females. Mononuclear cells derived from cord blood, which yielded much higher numbers of colonies than adult PBM, also responded to the stimulatory effect of E2. Estrone and estriol were less effective than E2 in adult PBM. In contrast, progesterone, diethylstilbestrol and testosterone did not affect the number of colonies at the range of physiological concentrations tested. The anti-estrogen Tamoxifen did not inhibit the stimulatory effect of E2. The augmenting effect of E2 on monomyelocytic colony formation may explain at least in part the increase in blood monocyte content of women with high E2 as well as other phenomena of macrophage and granulocyte changes associated with the menstrual cycle.     

雌激素受体亚型在子宫内膜增生中的表达

目的探讨雌激素受体(ER)亚型α和βmRNA及蛋白的异常表达在子宫内膜增生的发生发展中的作用。方法应用半定量逆转录聚合酶链反应(RT-PCR)和免疫组织化学链霉菌抗生物素蛋白一过氧化酶连接法(SP法)，检测18例正常子宫内膜组织、47例子宫内膜增生组织中ERα和ERβmRNA及蛋白的表达。结果①正常子宫内膜组ERβmRNA的平均表达水平低于子宫内膜增生组(P＜O．01)；②ERαmRNA和蛋白在不典型增生组织中的表达低于单纯型和复合型增生组织(P＜O．05)，ERβmRNA和蛋白在这三种类型的子宫内膜增生组织间没有差异。结论ERβmRNA的异常表达在子宫内膜增生发病中起重要作用，ERαmRNA和蛋白表达的下降与子宫内膜不典型增生的发生有关。     

妇科恶性肿瘤治疗后激素补充治疗和非激素治疗

妇科恶性肿瘤主要治疗方式包括手术、化疗和放疗。除少数能保留卵巢的患者外,大多数患者需行双卵巢切除。绝经前妇女,甚至绝经后短期的妇女术后会出现一系列的问题,包括潮热、多汗、失眠、情绪不稳定、抑郁等更年期症