大鼠卵巢组织中早期卵泡发育及卵母细胞凋亡与白藜芦醇的影响

目的:观察白藜芦醇对大鼠卵巢组织中早期卵泡发育及凋亡的影响。方法:实验于2006-07/12在汕头大学医学院细胞衰老实验室完成。成年SD大鼠合笼,所生的新生雌鼠分为3组:①对照组:正常出生者,不干预。②腹腔注射组:正常出生后12h内开始腹腔注射白藜芦醇25mg/(kg·d),1次/d。③母鼠灌胃组:正常怀孕的母鼠在孕12d(以发现阴道栓为怀孕0.5d)开始进行白藜芦醇25mg/(kg·d)灌胃,1次/d,直至分娩后生下的雌鼠。各组大鼠分别在出生2,4d处死取卵巢,应用苏木精-伊红染色观察大鼠早期卵泡发育情况(计算卵母细胞巢中卵母细胞及原始卵泡和发育卵泡的比率),应用TUNEL染色观察卵母细胞凋亡的情况。结果:①腹腔注射组和母鼠灌胃组大鼠卵母细胞巢内卵母细胞比例高于对照组[2d龄:(39.78±9.22)%,(53.20±5.08)%,(15.76±6.68)%;4d龄:(9.39±1.82)%,(5.39±2.12)%,(2.62±1.18)%;P均<0.05];2d龄母鼠灌胃组和腹腔注射组大鼠原始卵泡和发育卵泡比例低于对照组[原始卵泡:(57.64±7.23)%,(46.40±5.20)%,(74.57±9.36)%;发育卵泡:(2.58±2.41)%,(4.51±4.60)%,(9.67±4.70)%;P均<0.05]。②生后第2天是大鼠卵母细胞凋亡的高峰期,母鼠灌胃组和腹腔注射组卵泡凋亡率高于对照组,但差异不显著[(9.88±3.30)%,(12.95±3.34)%,(8.50±4.13)%,P>0.05]。结论:白藜芦醇可以延缓大鼠卵巢组织中卵母细胞巢破裂,抑制原始卵泡的发育启动;但是对于卵母细胞的凋亡没有明显影响。     

雌性大鼠运动性动情周期抑制与卵巢、子宫显微结构及相关激素水平的变化

目的:观察长时间大强度耐力运动对青春期雌性大鼠的动情周期、卵巢和子宫的显微结构及其相关激素水平表达的影响。方法:实验于2004-03/10在山东体育学院实验中心完成。选择有正常动情周期的健康2月龄雌性SD大鼠40只,数字表法随机分为对照组、大强度运动组(n=20)。大强度运动组采用递增负荷强度的跑台运动,在中国杭州段氏PT200跑台上进行,运动1h/d,每周运动6d,持续训练10周;对照组不施加干预,饲养笼内自由活动。训练过程中每天观察两组大鼠动情周期的变化,持续10周后,当大强度运动组大鼠的动情周期长时间停留在动情间期时,即发生动情周期抑制时,和对照组一起处死,采血并分离卵巢、子宫组织,光镜观察卵巢和子宫的显微结构变化,采用放免法测定血清雌激素、孕激素、胰岛素样生长因子1水平。结果:35只大鼠进入结果分析。①大强度运动组大鼠的动情周期均长时间停留在动情间期,表现为动情周期抑制现象。②与对照组相比,运动性动情周期抑制雌性大鼠的卵泡变小且数量变少、子宫腺数量变少且腺腔小。③运动性动情周期抑制雌性大鼠的血清雌激素、胰岛素样生长因子1和孕激素水平显著低于对照组[(17.54±9.72),(24.32±10.38)ng/L,P<0.05;(1016.08±269.38),(1285.65±297.77)μg/L,P<0.05;(26.84±14.09),(49.64±23.88)nmol/L,P<0.01]。结论:①长时间大强度运动引起雌性大鼠发生了运动性动情周期抑制现象,导致卵巢、子宫结构的改变。②血清雌激素、孕激素分泌的降低是运动性动情周期抑制的重要原因,胰岛素样生长因子1水平与运动性动情周期抑制的发生密切相关。     

长期力竭运动动情周期抑制模型大鼠卵巢组织形态和超微结构的变化

背景:研究运动性月经失调女性性腺和卵巢的功能,以及形态学的改变对于探讨运动性月经失调的发生机制具有重要意义。目的:通过建立长期力竭运动致动情周期抑制大鼠模型,观察卵巢的组织形态和细胞超微结构的变化。方法:正常3月龄SD雌性大鼠随机分成对照组和模型组,其中模型组大鼠每日进行一次力竭游泳运动直至其动情周期紊乱,取卵巢组织,苏木精-伊红染色,光镜下观察卵巢组织形态变化,电镜下观察卵巢细胞超微结构的变化。结果与结论:与对照组相比,模型组大鼠卵巢典型生长卵泡和新鲜黄体明显减少,原始卵泡、闭锁卵泡则相对增加,其颗粒细胞、黄体细胞内细胞器明显减少而含有大量的脂滴。提示长期力竭运动可抑制大鼠卵巢卵泡的发育、成熟、排卵与黄体形成,并使卵巢细胞的超微结构发生抑制性改变。     

子宫内膜异位症大鼠窦前卵泡、窦状卵泡和凋亡卵泡数目及血清性激素水平变化

目的探讨子宫内膜异位症大鼠血清性激素水平和卵泡发育及凋亡情况。方法取36只雌性SD大鼠,随机分为对照组(未进行处理)、假手术组(开腹后用丝线缝扎)和实验组(建立子宫内膜异位症模型),三组各12只。造模3周后,取实验组大鼠病灶组织,行苏木精-伊红染色,评价病理学改变,判断模型是否成功。取三组大鼠腹主动脉血,采用放射免疫法检测大鼠血清性激素的水平;取大鼠双侧卵巢组织,行TUNEL染色,并比较三组窦前卵泡、窦状卵泡和凋亡卵泡数目。结果实验组成功建立子宫内膜异位症模型,成模率为100. 00%。实验组血清雌二醇水平较对照组和假手术组明显下降(P 0. 05);而三组血清孕酮、促黄体生成激素(LH)和促卵泡生成激素(FSH)比较,均无显著性差异(P 0. 05)。实验组窦前卵泡和窦状卵泡数较对照组和假手术组明显减少,凋亡卵泡数较对照组和假手术组明显增多(P 0. 05);而对照组与假手术组窦前卵泡、窦状卵泡和凋亡卵泡数比较,均无显著性差异(P 0. 05)。结论通过建立子宫内膜异位症大鼠模型可知,子宫内膜异位症可导致雌二醇水平降低,对孕酮、LH和FSH水平无显著影响,可促使大鼠窦前卵泡和窦状卵泡数减少,诱导大鼠卵泡凋亡,对其卵泡发育造成极大的影响。     

大鼠胚胎卵巢冷冻保存和异体无血管皮下移植的生长

背景:胚胎卵巢组织免疫原性低,不易引起宿主的免疫排斥反应,是卵巢异体移植的理想供体.但由于获取胎儿卵巢的不随意性和来源限制,标本的冷冻显得至关重要,成功的冷冻保存和复苏技术是建立胎儿卵巢库的关键.目的:通过对大鼠新鲜或冻融胚胎卵巢组织异体无血管移植后的组织形态和功能的观察,探讨胚胎卵巢组织异体移植和超速冷冻保存的可行性.设计、时间及地点:随机对照动物实验.于2006-03/05在云南省第一人民医院生殖遗传科进行课题设计,于2006-05/2007-02在云南大学单克隆抗体研究中心完成实验.材料:卵巢来源于孕龄为18～20 d SD大鼠胚胎.取阴道脱落细胞涂片证实有正常动情周期未交配过的SD成年雌性大鼠作为移植对象,分4组:正常对照组(n=10)、去势对照组(n=10)、新鲜胚胎卵巢移植组(n=25)、冷冻胚胎卵巢移植组(n=25).方法:正常对照组仅行皮肤筋膜肌肉切开缝合术,去势对照组切除双侧卵巢组织.将孕龄为18～20 d的新鲜或经超速冷冻法冷冻复苏的大鼠胚胎卵巢植入去势后4周的大鼠颈部皮下作为实验组,分别为新鲜移植组和冷冻移植组.主要观察指标:通过阴道脱落细胞的观察和血清雌二醇、孕酮的测定了解大鼠内分泌恢复情况,并对移植卵巢进行组织学观察.结果:新鲜移植组和冷冻移植组分别有52.17%和38.01%大鼠恢复了动情周期,两组血清雌二醇和孕酮在分别在35和49 d恢复到正常,且动情周期天数与正常对照组比较,差异无显著性意义.冷冻移植组大鼠恢复动情周期虽稍短于新鲜移植组,但差异并无统计学意义.63 d后取出移植物观察,见移植物色泽红润,表面有丰富的血管形成,镜下见卵巢内有大量的小动脉和小静脉;移植物组织学检查发现卵泡的发育,光镜下可见不同发育阶段的卵泡,有成熟卵泡和黄体形成,形态与正常卵巢无明显差别.结论:大鼠胚胎卵巢异体异位无血管皮下移植后能存活、生长发育并具有与正常卵巢相似的内分泌功能;超速冷冻法能较好的保存胚胎卵巢的活性,复苏后与新鲜胚胎卵巢组织具有相同的生理活性.     

雌性大鼠运动性动情周期抑制与卵巢、子宫显微结构及相关激素水平的变化

目的：观察长时间大强度耐力运动对青春期雌性大鼠的动情周期、卵巢和子宫的显微结构及其相关激素水平表达的影响。 方法：实验于2004—03／10在山东体育学院实验中心完成。选择有正常动情周期的健康2月龄雌性SD大鼠40只，数字表法随机分为对照组、大强度运动组（n=20）。大强度运动组采用递增负荷强度的跑台运动，在中国杭州段氏PT200跑台上进行，运动1h／d，每周运动6d，持续训练10周；对照组不施加干预，饲养笼内自由活动。训练过程中每天观察两组大鼠动情周期的变化，持续10周后，当大强度运动组大鼠的动情周期长时间停留在动情间期时，即发生动情周期抑制时，和对照组一起处死，采血并分离卵巢、子宫组织，光镜观察卵巢和子宫的显微结构变化，采用放免法测定血清雌激素、孕激素、胰岛素样生长因子1水平。 结果：35只大鼠进入结果分析。①大强度运动组大鼠的动情周期均长时间停留在动情间期，表现为动情周期抑制现象。②与对照组相比，运动性动情周期抑制雌性大鼠的卵泡变小且数量变少、子宫腺数量变少且腺腔小。③运动性动情周期抑制雌性大鼠的血清雌激素、胰岛素样生长因子1和孕激素水平显著低于对照组[（17．54&;#177;9．72），（24．32&;#177;10．38）ng／L，P〈0．05；（1016．08&;#177;269．38），（1285．65&;#177;297．77）μg／L，P〈0．05；（26．84&;#177;14．09），（49．64&;#177;23．88）nmoL／L,P〈0．01]。 结论：①长时间大强度运动引起雌性大鼠发生了运动性动情周期抑制现象，导致卵巢、子宫结构的改变。②血清雌激素、孕激素分泌的降低是运动性动情周期抑制的重要原因，胰岛素样生长因子1水平与运动性动情周期抑制的发生密切相关。     

长期力竭运动动情周期抑制模型大鼠卵巢组织形态和超微结构的变化

背景：研究运动性月经失调女性性腺和卵巢的功能,以及形态学的改变对于探讨运动性月经失调的发生机制具有重要意义。目的：通过建立长期力竭运动致动情周期抑制大鼠模型,观察卵巢的组织形态和细胞超微结构的变化。方法：正常3月龄SD雌性大鼠随机分成对照组和模型组,其中模型组大鼠每日进行一次力竭游泳运动直至其动情周期紊乱,取卵巢组织,苏木精-伊红染色,光镜下观察卵巢组织形态变化,电镜下观察卵巢细胞超微结构的变化。结果与结论：与对照组相比,模型组大鼠卵巢典型生长卵泡和新鲜黄体明显减少,原始卵泡、闭锁卵泡则相对增加,其颗粒细胞、黄体细胞内细胞器明显减少而含有大量的脂滴。提示长期力竭运动可抑制大鼠卵巢卵泡的发育、成熟、排卵与黄体形成,并使卵巢细胞的超微结构发生抑制性改变。     

Peroxiredoxin Ⅳ mRNA在小鼠卵泡发育和卵巢衰老过程中的表达

目的:探讨Peroxiredoxin(PRDX) Ⅳ mRNA在小鼠卵泡发育和卵巢衰老过程中表达。方法:选用C57BL/6j小鼠不同周龄、动情周期以及促性腺激素预处理卵巢,通过实时定量聚合酶链反应检测PRDX Ⅳ mRNA表达。结果:PRDX Ⅳ mRNA在3周龄、6周龄、8月龄卵巢中表达分别为新生3d小鼠的0.76、0.42、0.12(P<0.05);在性成熟小鼠各动情周期卵巢中表达无差异;在未成熟小鼠促性腺激素预处理卵巢中,PMSG注射48h表达为生理盐水注射组(CON组)的1.63倍(P<0.05),于HCG注射后4、8、12、48h分别为CON组的0.81、0.56、0.78、0.66(P<0.05)。结论:PRDX Ⅳ可能通过调节卵泡发育与卵巢氧化应激压力而调控卵巢衰老过程。     

中成药坤宁安调控围绝经期大鼠卵巢颗粒细胞凋亡因子Bcl-2 mRNA表达的特点

目的:观察中成药坤宁安对围绝经期大鼠卵巢颗粒细胞凋亡的影响。方法:实验于2004年在黑龙江中医药大学完成。选用13～15个月龄雌性Wistaer大鼠50只,经阴道脱落细胞涂片检查,呈现出无动情周期确定为围绝经期鼠。随机分为5组,围绝经期模型组、坤宁安高剂量组,坤宁安低剂量组、替勃龙对照组、更年康对照组,每组10只。另选5月龄雌性Wistar大鼠10只作为青年对照组。围绝经期模型组给予生理盐水2mL,坤宁安高剂量组给予1.96g/kg坤宁安混悬液穴组成为柴胡、桂枝、龙骨、牡蛎、白芍、当归等雪;坤宁安低剂量组给予0.49g/kg坤宁安混悬液;替勃龙对照组给予0.136mg/kg替勃龙混悬液;更年康对照组给予0.15g/kg更年康混悬液;青年对照组给予生理盐水2mL,灌胃1次/d。灌胃4周后,断头处死,剖取大鼠卵巢,即供原位杂交法检测Bcl-2mRNA的表达。卵巢颗粒细胞凋亡因子Bcl-2mRNA阳性评定标准:根据切片卵巢组织中卵泡内颗粒细胞免疫组织化学染色的深浅分4级,未被染色的为阴性表达,深棕色为弱阳性表达,棕黄色为中度阳性表达,棕褐色为强阳性表达。为统计方便,予以半定量计分:1,2,3,4分别对应阴性表达,弱阳性表达,中度阳性表达,强阳性表达。每张切片至少观察3个视野。结果:实验过程中,围绝经期模型组、更年康对照组各有1只大鼠死亡。其余大鼠均存活直至实验结束。青年对照组大鼠卵巢颗粒细胞Bcl-2mRNA呈强阳性表达,围绝经期模型组大鼠卵巢颗粒细胞Bcl-2mRNA呈弱阳性表达,青年对照组与之相比差异有极显著性意义(P<0.01)。坤宁安高、低剂量组、替勃龙对照组大鼠卵巢颗粒细胞均有不同程度的Bcl-2mRNA阳性表达,与围绝经期模型组大鼠比较差异均有极显著性意义(P<0.01),更年康对照组大鼠卵巢颗粒细胞Bcl-2mRNA蛋白表达呈弱阳性,与围绝经期模型组比较差异有显著性意义(P<0.05)。结论:围绝经期大鼠卵巢颗粒细胞凋亡与Bcl-2mRNA的阳性表达呈负相关,坤宁安通过调控大鼠卵巢颗粒细胞Bcl-2mRNA的表达,达到延缓卵巢颗粒细胞凋亡的目的。     

促卵泡刺激素干预改善绵羊卵巢组织玻璃化冻存后异种移植的效果研究

背景:卵巢皮质片移植是无血管吻合移植,因此,提高卵巢组织对冻存-解冻和移植后缺血的耐受力是提高冻存后移植物卵泡存活和延长功能寿命的关键环节.目的:观察促卵泡刺激素在玻璃化冻存过程中对绵羊卵巢组织形态和功能的保存效果,为成人卵巢组织的冻存提供技术方法.方法:BALB/c品系雌性裸鼠随机分为3组.均行羊卵巢皮质片裸鼠异位移植:①新鲜移植对照组,取材后即移植.②玻璃化冻存移植组,采用玻璃化冻存解冻后移植,所用液体均未添加促卵泡刺激素.③添加促卵泡刺激素的玻璃化冻存移植组,采用冷冻液、解冻液和培养液均添加促卵泡刺激素的玻璃化冻存后移植.移植后检测受体鼠动情周期恢复率、恢复时间、卵泡数和发育状况,于移植后4周取移植卵巢进行组织学观察、并行血清雌二醇水平分析.结果与结论:含促卵泡刺激素的玻璃化冻存移植组与新鲜移植组相比动情周期恢复率、每高倍视野卵泡计数差异均无显著性意义(P>0.05),卵泡计数高于未添加促卵泡刺激素的玻璃化冻存移植组(P<0.05);动情周期恢复需要的天数接近于新鲜移植组,明显短于未添加促卵泡刺激素的玻璃化冻存移植组(P<0.05).移植后4周,含促卵泡刺激素的玻璃化冻存移植组组织学观察见卵泡发育,未添加促卵泡刺激素的玻璃化冻存移植组仅偶见原始卵泡.含促卵泡刺激素的玻璃化冻存移植组与新鲜移植组相比血清雌二醇水平差异无显著性意义(P>0.05),显著高于未添加促卵泡刺激素的玻璃化冻存移植组(P< 0.05).结果提示,在玻璃化液中加入促卵泡刺激素可提高冻存绵羊卵巢组织移植后卵泡存活率.     

经阴道彩色多普勒超声对健康生育期妇女卵巢动脉血流状况的评价

目的探讨健康生育期女性卵巢血流在正常月经周期中血流动力学变化的特点及规律,为临床了解卵巢血流的生理和病理变化提供客观的参考指标。方法应用经阴道彩色多普勒超声对50例健康生育期女性的卵泡期、排卵期、黄体期及黄体萎缩期进行检查,观测卵巢动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)、血流阻力指数(RI)、搏动指数(PI)及收缩与舒张末流速比(S/D)等指标。结果除卵泡期、黄体萎缩期之外,卵巢动脉的EDV、RI、PI、S/D组间比较均存在显著性差异(P0.05),黄体期RI、PI、S/D最低,黄体萎缩期RI、PI、S/D最高(P0.05)。结论健康生育期女性在正常月经周期中卵巢动脉血流呈周期性变化,其血供状态与功能状态密切相关。通过检测血流参数可为临床了解卵巢功能提供客观的参考指标。     

Control of ovarian primordial follicle activation

The ovarian follicles develop initially from primordial follicles. The majority of ovarian primordial follicles are maintained quiescently as a reserve for the reproductive life span. Only a few of them are activated and develop to an advanced follicular stage. The maintenance of dormancy and activation of primordial follicles are controlled by coordinated actions of a suppressor/activator with close communications with somatic cells and intra-oocyte signaling pathways. Many growth factors and signaling pathways have been identified and the transforming growth factor-beta superfamily plays important roles in early folliculogenesis. However, the mechanism of maintaining the dormancy and survival of primordial follicles has remained unknown for decades. Recently, since the first finding that all primordial follicles are activated prematurely in mice deficient forkhead box O3a, phosphatidylinositol 3 kinase/phosphatase and tensin homolog (PTEN) signaling pathway was reported to be important in the regulation of dormancy and initial follicular activation. With these informations on early folliculogenesis, clinical application can be expected such as in vitro maturation of immature oocytes or in vitro activation of follicles by PTEN inhibitor in cryopreserved ovarian cortical tissues for fertility preservation.     

Three-dimensional power Doppler imaging of ovarian stromal blood flow in women with endometriosis undergoing in vitro fertilization.

OBJECTIVE: The aims of this retrospective study were to investigate whether the quantification of ovarian stromal blood flow and/or leptin concentration are predictive of in vitro fertilization (IVF) outcomes in women after laparoscopic ovarian cystectomy for large endometriomas. METHODS: Twenty-two women undergoing IVF after laparoscopic surgery for ovarian endometriomas (> 6 cm) comprised the study group. Twenty-six women with tubal factor infertility constituted the control group. Ovarian stromal blood flow was evaluated by three-dimensional (3D) power Doppler ultrasound imaging using virtual organ computer-aided analysis (VOCAL( trade mark )). Serum and follicular fluid (FF) leptin concentrations were quantified using an enzyme-linked immunosorbent assay kit. RESULTS: There were significantly decreased ovarian stromal blood flow parameters (including vascularization index, flow index (FI), and vascularization flow index) in the endometriosis group without an evident difference in total ovarian volume on the day of human chorionic gonadotropin. The value of FF leptin demonstrated a negative correlation with ovarian stromal FI in the control group, but there was a loss of this effect in the endometriosis group. CONCLUSIONS: Quantification of ovarian stromal blood flow by 3D power Doppler ultrasound in women with endometriosis may provide an important prognostic indicator in those undergoing IVF.     

Sonographic findings of prenatal torsion of ovarian lymphangioma

Ovarian cysts are primarily of follicular origin, and ovarian lymphangioma is an extremely rare lesion. Most ovarian cysts demonstrated on prenatal sonograms are asymptomatic and resolve antenatally. We report a case of ovarian torsion in utero secondary to an ovarian lymphangioma in which sonographic examination revealed a changing pattern of the cystic ovarian mass from an anechoic to echogenic appearance.     

The pattern of changes in ovarian stromal and uterine artery blood flow velocities during in vitro fertilization treatment and its relationship with outcome of the cycle.

OBJECTIVES: To assess the effect of short-term (2-3 weeks) pituitary suppression and controlled ovarian stimulation on ovarian and uterine artery Doppler measurements during the in vitro fertilization (IVF) treatment cycle and to compare the pattern of these changes between conception and non-conception cycles as well as between patients with normal and those with polycystic ovaries. DESIGN: Prospective observational study of women undergoing IVF treatment. SUBJECTS: Women using the long-treatment buserelin protocol who did not have uterine fibroids, ovarian cysts or endometrioma. METHODS: Serial transvaginal color and pulsed Doppler measurements of ovarian stromal and uterine artery blood flow velocity were carried out in the early follicular phase of the menstrual cycle, on the day of pituitary suppression and on the day of administration of human chorionic gonadotropin (hCG). The main outcome measures were the ovarian stromal and uterine artery blood flow peak systolic velocity (PSV) and pulsatility index (PI). RESULTS: A total of 105 patients were recruited but six patients were excluded from the analysis because they had only one stage of the measurements performed. There was a significant decline in mean ovarian stromal artery PSV after 2-3 weeks of gonadotropin releasing hormone (GnRH) agonist therapy but no effect on ovarian stromal artery PI. The mean uterine artery PSV or PI did not change significantly after 2-3 weeks of GnRH agonist therapy. There was a significantly higher mean ovarian stromal artery PSV in conception cycles compared to non-conception cycles in the early follicular phase and on the day of pituitary suppression, but not on the day of hCG administration. There were no differences between conception and non-conception cycles in the mean uterine artery PSV or PI. Women with polycystic ovaries had a higher mean ovarian artery PSV on all the three occasions of measurement. CONCLUSION: These data suggest that assessment of ovarian blood flow before commencement of gonadotropin stimulation may play a role in assessing cycles likely to result in pregnancy.     

Effect of total abdominal hysterectomy on ovarian blood supply in women of reproductive age.

OBJECTIVE: The purpose of this study was to evaluate the effect of total abdominal hysterectomy on ovarian blood supply using transvaginal color Doppler ultrasonography in women of reproductive age. METHODS: This prospective study included 61 women aged 40 years or younger who were divided into 2 groups: group 1, comprising 31 patients who underwent total abdominal hysterectomy (TAH); and group 2, comprising 30 women with no abnormalities. Inclusion criteria included normal ovarian function at baseline, with basal follicle-stimulating hormone levels of less than 15 mUI/mL, normal body weight, no tobacco use, and no history of laparotomy or ovarian disease. Ovarian arterial blood supply by determination of the pulsatility index (PI) on Doppler analysis and ovarian volume on transvaginal ultrasonography were assessed at baseline and at 6 and 12 postoperative months. The Student t test, profile analysis, and Friedman and Mann-Whitney tests were used in the statistical analysis of data. RESULTS: Statistical analysis of baseline data revealed that both groups were homogeneous. At months 6 and 12, greater ovarian volumes and lower PI values were observed in patients who underwent TAH (P < .05). By the end of the study, in 8 of the 31 patients who underwent TAH (25.5%), benign ovarian cysts were observed. In the control group, all the parameters studied remained unchanged. CONCLUSIONS: The reduced PI values observed on Doppler ultrasonography suggested a decrease in the resistance flow in the ovarian arteries in women of reproductive age who underwent TAH.     

Physiology of ovarian function

The ovarian function including follicular maturation, ovulation and corpus luteum formation is regulated by a complex control system composed of hypothalamus, pituitary and the ovary itself. These organs communicate via positive and negative feedback loops and can be considered as a functional entity. Special neurons in the hypothalamus produce gonadotropin-releasing hormone (GnRH) being delivered to the anterior pituitary lobe by the pituitary portal vessels. GnRH binds to specific receptors inducing synthesis and release of the gonadotropins FSH and LH into the circulation. After binding to their specific receptors at the ovary FSH and LH induce follicular maturation, ovulation and corpus luteum formation. The ovary responds to gonadotropin stimulation in dual fashion: secretion of sexsteroids and the liberation of a fertilizable oocyte. In addition the ovary is also able to secrete peptide-hormones such as inhibin and activin. Sexsteroids and inhibin modulate the pulsatile secretion of GnRH and gonadotropins. Cooperation of theca- and granulosa cells at the ovarian level and the corpus luteum formation are described and the significance of growth factors and cytocines is emphasized. The effects of estradiol and progesterone are highlighted by the morphological response of the endometrium. The ovary is actively involved in maintaining cyclicity, as reflected by the processes of follicular growth, follicle rupture and formation of the corpus luteum with the dramatic morphological changes involved.     

Cellular immunotherapy for ovarian cancer

Background: Ovarian cancer is frequently diagnosed at an advanced stage, and although initially responsive to surgery and chemotherapy, has a high rate of recurrence and mortality. Cellular immunotherapy may offer the prospect of treatment to prevent or delay recurrent metastatic disease. Objective: To provide an overview of current innovations in cellular immunotherapy for ovarian cancer, with an emphasis on dendritic cell vaccination and adoptive T-cell immunotherapy. Methods: Three key areas are explored in this review: first, an appraisal of the current state of the art of cellular immunotherapy for treatment of ovarian cancer; second, a discussion of the immunological defenses erected by ovarian cancer to prevent immunological attack, with an emphasis on the role of tumor-associated regulatory T cells; and third, an exploration of innovative techniques that may enhance the ability of cellular immunotherapy to overcome ovarian tumor-associated immune suppression. Results/conclusion: Ovarian cancer is recognized as a paradigm for tumor-associated immune suppression. Innovative approaches for antagonism of tumor-associated regulatory T-cell infiltration and redirection of self antigen-driven regulatory T-cell activation may provide the key to development of future strategies for cellular immunotherapy against ovarian cancer.     

超声评价克罗米酚治疗多囊卵巢综合征疗效的临床意义

目的：预测克罗米酚（ＣＣ）疗效,指导治疗方案的选择。方法：４１例多囊卵巢综合征（ＰＣＯＳ）患者服ＣＣ前后测定血清生殖激素水平、Ｂ超了解卵巢形态并监测排卵。结果：基础雄烯二酮（Ａ）、游离睾酮（ＦＴ）在无反应组高于有反应组（Ｐ＜０．０１）;Ａ≥３．３９ｎｇ／ｍｌ、ＦＴ≥１７．５６ｐｍｏｌ／Ｌ为ＣＣ抵抗组的激素特征。超声显示无反应组平均卵泡数增多、平均卵巢体积及平均髓质面积增大高于有反应组（Ｐ＜０．０５）;平均卵泡数≥１０个、平均卵巢体积≥１０．５０ｃｍ３、平均髓质面积≥１．７２ｃｍ２为ＣＣ抵抗组的超声特征。结论：卵巢超声形态评价结合血清生殖激素测定可初步预测ＣＣ疗效,对临床选择治疗方案有重要指导价值。