LA辅助促进排卵对金黄地鼠子宫内膜分泌与合成蛋白的影响

对模仿人类体外受精（ＩＶＦ）的动物模型金黄地鼠的子宫内膜蛋白分泌及合成进行研究。结果表明：蛋白的分子量迁移在３１￣６６ＫＤ，但蛋白电泳照片示在Ｌｅｕｐｒｏｌｉｄｅ Ａｃｅｔａｔｅ（ＬＡ）组其蛋白带密度明显低于孕马血清促性腺激素（ＰＭＳＧ）组；而新合成蛋白分析示在低分子和中分子量（３１ＫＤ和４５ＫＤ）ＬＡ组却明显高于ＰＭＳＧ组。且ＬＡ组分泌及合成蛋白均与无促排卵组（对照组）相似。该资料提示：使用ＬＡ     

IVF失败患者月经期子宫内膜雌、孕激素受体变化对复融周期妊娠率的影响

目的:探讨体外受精-胚胎移植/卵胞浆内单精子注射(IVF/ICSI)周期失败患者复融周期月经期子宫内膜雌、孕激素受体变化对妊娠率的影响。方法:选取2009年1月～2010年1月IVF/ICSI周期失败患者,复融周期月经来潮24 h内行内膜搔刮术,将刮出物中少量子宫内膜组织送病理检查。按子宫内膜病理分型,分为分泌正常、分泌反应欠佳、增生反应型子宫内膜,比较各组子宫内膜雌、孕激素受体变化及复融周期胚胎种植率、妊娠率及流产率。结果:共获病理报告317例,分泌正常子宫内膜共96例,分泌反应欠佳子宫内膜共143例,增生反应型子宫内膜共78例。增生反应组宫外孕发生率(6.41%)高于分泌反应正常组(0.00%)和分泌反应欠佳组(1.39%),差异有统计学意义(P<0.05)。分泌反应正常组的胚胎着床率(45.79%)和生化妊娠率(62.5%)均高于分泌反应欠佳组(38.08%,50.35%)和增生反应组(34.84%,47.43%),但差异无统计学意义(P>0.05)。分泌反应欠佳组流产率(14.69%)高于分泌反应正常组(7.29%)和增生反应组(8.97%),但差异无统计学意义(P>0.05)。结论:复融周期胚胎移植可以选择分泌良好的周期进行,以提高移植的成功率。     

Bcl-2蛋白在子宫内膜异位症的表达及意义

目的 :检测正常子宫内膜及内膜异位症的在位、异位内膜 Bcl-2蛋白表达及细胞凋亡率 ,探讨其在子宫内膜异位症发生机制中的作用。方法 :采用免疫组化方法对 50例同期因宫颈癌 I期 ,输卵管节育术患者及盆腔子宫内膜异位症患者 47例的在位、异位内膜 Bcl-2蛋白表达及应用流式细胞技术检测细胞凋亡率。结果 :1对照组 :子宫内膜的 Bcl-2蛋白主要表达于子宫内膜腺上皮细胞浆和 /或细胞膜上。增生期 Bcl-2蛋白的表达显著高于分泌期 (P<0 .0 1)。 2内膜异位症组 :在位内膜的 Bcl-2蛋白亦主要表达于子宫内膜腺上皮细胞胞浆和 /或胞膜上 ,增生期 Bcl-2蛋白表达与分泌期有显著性差异 (P<0 .0 1)。异位症组异位内膜增生期、分泌期无显著性差异 (P>0 .0 5)。 3异位症组 :异位内膜与在位内膜分泌期比较 Bcl-2蛋白表达有显著性差异 (P<0 .0 5)。 4内膜异位症组与对照组比较 :其分泌期 Bcl-2蛋白表达显著高于对照组的分泌期 (P<0 .0 1)。内膜异位症在位内膜细胞凋亡率低于正常子宫内膜。异位内膜细胞 AP峰明显低于异位症在位内膜细胞和正常子宫内膜细胞。结论 :1子宫内膜周期性生理变化与 Bcl-2蛋白表达水平有关。子宫内膜的周期性变化可能与凋亡有关。 Bcl-2蛋白的表达水平越高 ,组织的抗凋亡性越强。 2异位内膜细胞凋?     

IVF-ET时子宫容受性评价

体外受精(IVF)的成功有赖于治疗环节中许多因素,其中包括胚胎的质量和子宫内膜的容受性。对胚胎质量与IVF的关系进行了广泛的研究,建立了一个统一的诊断标准;而对子宫内膜容受性在IVF时的影响及如何对其进行评价并不明确。目前多通过对子宫内膜的厚度、形态、血流以及在IVF超促排卵时激素水平对子宫内膜的影响进行评估,但结果并不令人满意。总之IVF的成功受多个环节的影响,任何环节的异常都会影响其成功率。     

多囊卵巢综合征患者促排卵治疗后子宫内膜组织GLUT4的表达及意义

目的:观察多囊卵巢综合征(PCOS)患者经过胰岛素增敏剂和促排卵治疗后子宫内膜葡萄糖转运蛋白4(GLUT4)在基因水平和蛋白水平的表达,探讨改善胰岛素敏感性对PCOS子宫内膜的影响。方法:应用免疫组织化学法、反转录聚合酶链法(RT-PCR)比较PCOS组(20例PCOS患者)和对照组(15例月经规则的育龄妇女)子宫内膜GLUT4、胰岛素(INS)和胰岛素受体(INS-R)蛋白和基因水平的表达。结果:GLUT4、INS及INS-R的蛋白和mRNA在两组子宫内膜中均有表达,PCOS组GLUT4蛋白和mRNA表达强度均低于对照组(P<0.05、P<0.05),INS蛋白和mRNA表达水平均明显高于对照组(P<0.01、P<0.01),INS-R蛋白表达水平明显低于对照组(P<0.05),INS-R mRNA表达水平与对照组无显著性差异(P>0.05)。结论:PCOS患者经过胰岛素增敏剂和促排卵治疗后,子宫内膜GLUT4蛋白和基因水平的表达与对照组相比有差异,推测PCOS患者子宫内膜GLUT4的表达和转位受多因素影响。     

IVF-ET时子宫容受性评价

体外受精(IVF)的成功有赖于治疗环节中许多因素,其中包括胚胎的质量和子宫内膜的容受性.对胚胎质量与IVF的关系进行了广泛的研究,建立了一个统一的诊断标准;而对子宫内膜容受性在IVF时的影响及如何对其进行评价并不明确.目前多通过对子宫内膜的厚度、形态、血流以及在IVF超促排卵时激素水平对子宫内膜的影响进行评估,但结果并不令人满意.总之IVF的成功受多个环节的影响,任何环节的异常都会影响其成功率.     

IVF—ET时子宫容受性评价

体外受精(IVF)的成功有赖于治疗环节中许多因素，其中包括胚胎的质量和子宫内膜的容受性。对胚胎质量与IVF的关系进行了广泛的研究，建立了一个统一的诊断标准；而对子宫内膜容受性在IVF时的影响及如何对其进行评价并不明确。目前多通过对子宫内膜的厚度、形态、血流以及在IVF超促排卵时激素水平对子宫内膜的影响进行评估，但结果并不令人满意。总之IVF的成功受多个环节的影响，任何环节的异常都会影响其成功率。     

子宫内膜组织中PTEN表达与Akt信号通路的相关性

目的:探讨抑癌基因PTEN与子宫内膜癌发生、发展的关系及与Akt信号传导通路的相关性。方法:应用半定量逆转录聚合酶链反应(RT-PCR)方法和Western-blot方法测定24例子宫内膜癌、10例子宫内膜非典型增生、10例子宫内膜增殖症和10例正常子宫内膜组织PTENmRNA和蛋白水平的表达及Akt磷酸化水平的变化;免疫组织化学SP法检测增生期内膜31例(增生期组),分泌期内膜30例(分泌期组),内膜增殖症71例(增殖症组),非典型增生内膜25例(非典型增生组),子宫内膜癌73例(内膜癌组)组织中PTEN蛋白水平的表达,将结果与各病例的组织学类型、组织学分级、肌层浸润深度和临床分期等生物学行为进行相关性分析。结果:PTEN在增生期组、分泌期组、增殖症组、非典型增生组、内膜癌组的免疫组化染色强度分别为:3.39±0.15、1.90±0.21、3.34±0.29、0.62±0.11、0.74±0.19,mRNA相对含量在正常内膜、增殖症、非典型增生及内膜癌组中分别为2.45±0.51、2.32±0.32、0.46±0.11、0.35±0.13。在转录和蛋白水平子宫内膜腺癌组和癌前病变组中PTEN的表达明显低于内膜增殖症组和正常子宫内膜组(P<0.0001)。PTEN蛋白表达与组织学类型、组织学分级和临床分期有关(P<0.05),与子宫内膜癌肌层浸润深度无关(P>0.05)。Western-blot结果显示,phospho-Akt表达水平在PTEN表达阴性病例中明显升高,与PTEN表达呈负相关(r=-0.8973,P<0.0001)。结论:PTEN表达缺失是子宫内膜癌发生的早期事件;PTEN蛋白表达缺失导致Akt信号传导通路持续活化参与了子宫内膜癌的发生、发展。     

控制性超促排卵治疗与子宫内膜

生理情况下人类胚胎着床大约发生在排卵后第7d左右,在体外受精、胚胎移植(IVF—ET)等辅助生殖技术中应用药物进行控制性超促排卵(COH),来得到较多的卵子数。但控制性超促排卵使子宫内膜着床窗发生改变,影响胚胎着床率。超促排卵对子宫内膜的影响可能出现在以下方面:①使子宫内膜组织学分日与生理不符、腺体发育和间质发育的同步性发生改变。②扫描电镜观察子宫内膜超微结构-胞饮突表达异常,导致内膜种植窗开放与胚胎发育不同步。③子宫内膜的激素受体表达异常,改变内膜对激素的反应。控制性超促排卵治疗使子宫内膜形态学、组织学、激素受体发生变化,导致子宫内膜种植窗开放异常,影响辅助生殖技术的成功率。     

预备周期子宫内膜glycodelin、galectin-3表达评估IVF子宫内膜容受性

目的:探讨子宫内膜着床窗口期glycodelin、galectin-3表达评价体外受精-胚胎移植(IVF-ET、简称IVF)子宫内膜容受性。方法:接受IVF治疗患者,前一月经周期HCG日,阴道超声子宫内膜厚度和形态;着床窗口期子宫内膜采用RT-PCR技术检测glycodelin mRNA、galectin-3mRNA表达,评价其与妊娠的关系。结果:185例IVF患者,90例妊娠,95例未妊娠,比较妊娠组HCG日内膜厚度和三线型比例与IVF未妊娠组无统计学差异,妊娠组子宫内膜着床窗口期glycodelin、ga-lectin-3的表达明显高于未妊娠组。结论:子宫内膜着床窗口期glycodelin、galectin-3的表达可用于评估子宫内膜容受性;子宫内膜厚度和形态不能完全评价子宫内膜容受性。     

寿胎丸对控制性超排卵小鼠子宫内膜血管内皮生长因子及其受体的影响研究

目的探讨寿胎丸提高控制性超排卵(Controlled Ovarian Hyperstimulation,COH)小鼠子宫内膜容受性的作用机制。方法采用促性腺激素释放激素激动剂+血清促性腺激素+人绒毛膜促性腺激素建立COH小鼠模型,将其分为模型组、寿胎丸高、中、低剂量组、阿司匹林对照组、同时设正常对照组,在造模的同时,寿胎丸高、中、低剂量组分别按6、3、1 g/kg寿胎丸灌胃;阿司匹林对照组按0.2 g/kg阿司匹林灌胃;模型组、正常对照组以等体积生理盐水灌胃,1次/d,连用11 d。采用HE染色、免疫组化法对子宫进行病理切片制作,通过Mias-2000图像分析系统检测子宫内膜血管内皮生长因子(Vascular Endothelial Growth Factor,VEGF)、血管内皮细胞生长因子受体-1(Vascular Endothelial Growth Factor Receptor-1,VEGFR-1)蛋白表达水平,并测量子宫内膜厚度及其血管数。结果与正常对照组比较,模型组、寿胎丸高、中、低剂量组、阿司匹林对照组子宫内膜厚度无明显变化;模型组子宫血管数、内膜VEGF、VEGFR-1明显减少(P0.05)。与模型组比较,寿胎丸高、中、低剂量组、阿司匹林对照组子宫血管数、内膜VEGF明显增多(P0.05),寿胎丸高剂量组、阿司匹林对照组子宫内膜VEGFR-1明显增多(P0.05)。结论寿胎丸可能通过促进COH小鼠子宫内膜VEGF及受体表达、增加子宫血管数量,进而提高COH小鼠子宫内膜容受性。     

Effect of commercially available PMSG on maturation, fertilization and embryo development of buffalo oocytes in vitro

In vitro fertilization (IVF) technology provides an opportunity to produce embryos for genetic manipulation, embryo transfer and basic research in developmental physiology, and can be exploited for emerging biotechnologies such as transgenesis and cloning. In the present study, the effects of different concentrations of commercially available pregnant mare serum gonadotrophin (PMSG) (Folligon; Intervet, International B.V, Boxmeer, Holland) in oocyte culture media, on maturation, fertilization and embryonic development of buffalo oocytes in vitro were investigated. Oocytes aspirated from abattoir-derived ovaries were cultured in media containing TCM-199 + PMSG at 0, 2.5, 20, 30, 40 and 50 IU mL(-1) in presence or absence of steer serum (10%) for 24 h in a CO2 incubator. The maturation rate was assessed on the basis of degree of expansion of cumulus cells. The matured oocytes were inseminated with 9-10 x 10(6) spermatozoa mL(-1) in Brackett and Oliphant medium and the cleavage rate was recorded 40-42 h after insemination. Uncleaved oocytes were stained with aceto-orcein for evaluation of fertilization rates. The cleaved embryos were further cultured in TCM-199 + 10% steer serum on buffalo oviducal cell monolayer for 7 days. Maturation, fertilization, cleavage and embryonic development were significantly higher (P < 0.05) in oocytes cultured in TCM-199 + 10% steer serum supplemented with 40 and 50 IU PMSG mL(-1). It is concluded that commercially available PMSG can effectively be used in place of pure follicle-stimulating hormone for in vitro maturation of buffalo oocytes, making it cost effective for IVF studies.     

Leuprolide Acetate Suppresses Pedophilic Urges and Arousability

Cognitive–behavioral psychotherapy was compared with cognitive–behavioral psychotherapy augmented by leuprolide acetate (LA) for suppression of pedophilic behavior. Five male pedophiles (M age, 50 years; range, 36–58) were administered LA by Depo injection for 12 months, followed by saline placebo for 12 months. Testosterone levels, sexual interest preference by visual reaction time (Abel Assessment), penile tumescence (Monarch Penile Plethysmography, PPG), as well as strong sexual urges toward children and masturbatory frequency involving thoughts of children (polygraph), were measured every 3 months. On LA, testosterone decreased to castrate levels. Penile tumescence was significantly suppressed compared with baseline, but sufficient response remained to detect pedophilic interest. Pedophilic interest was also detected by visual reaction times. When asked about having pedophilic urges and masturbating to thoughts of children, all subjects self-reported a decrease. Polygraph responses indicated subjects were not deceptive. On placebo, testosterone and physiologic arousal eventually rose to baseline. As noted by polygraph, at baseline and on placebo, subjects were deceptive regarding increased pedophilic urges and masturbatory frequency. Interest preference, as measured by Abel Assessment and Monarch PPG, was generally unchanged throughout the study. Cognitive–behavioral psychotherapy augmented with LA significantly reduced pedophilic fantasies, urges, and masturbation; however, pedophilic interest did not change during 1 year of therapy. Deceptive responses by polygraph suggested that self-report was unreliable. Follow-up utilizing objective measures is essential for monitoring efficacy of treatment in pedophilia. Our study supports the premise that suppression of pedophilic behavior is possible. LA may augment cognitive–behavioral psychotherapy and help break the sequence leading to a re-offense.     

种植窗口期子宫内膜中MMP-9、TIMP-1及ICAM-1的表达与体外受精-胚胎移植妊娠结局的关系

目的:探讨种植窗口期子宫内膜中MMP-9、TIMP-1和ICAM-1的表达及其与体外受精-胚胎移植妊娠结局的关系。方法:收集40例拟行IVF/ICSI-ET妇女前1周期黄体中期的子宫内膜组织,分别检测妊娠组与非妊娠组中MMP-9、TIMP-1及ICAM-1的表达。结果:与妊娠组相比,非妊娠组中MMP-9、TIMP-1及ICAM-1的表达显著降低,差异有显著性(P<0.05)。结论:种植窗口期子宫内膜中MMP-9、TIMP-1及ICAM-1表达降低,影响胚胎的着床,降低妊娠率,可作为预测IVF/ICSI-ET妊娠结局的指标之一。     

整合素β3和细胞间隙连接蛋白43与体外受精-胚胎移植妊娠结局的关系

目的:探讨子宫内膜整合素β3、细胞间隙连接蛋白43表达水平与体外受精-胚胎移植妊娠结局的关系,进而分析其与子宫内膜容受性的相关性。方法:前瞻性收集了IVF/ICSI-ET病例36例,其中11例临床妊娠者作为妊娠组,25例未妊娠者作为非妊娠组。于黄体中期取内膜,应用单克隆抗体免疫组化方法检测子宫内膜整合素β3和Cx43表达情况。结果:妊娠组与非妊娠组子宫内膜腔上皮整合素β3表达的HSCORE平均分数分别为0.55(0.00~1.60)和0.07(0.00~1.10),差异有显著性(P=0.02);而子宫内膜腺上皮整合素β3表达比较,两组之间差异无显著性;子宫内膜间质细胞和上皮细胞中Cx43表达在两组均未发现统计学差异。结论:子宫内膜腔上皮整合素β3表达水平可能与体外受精-胚胎移植妊娠结局有相关性。     

Complementary roles of hysteroscopy and saline infusion hysterosonography in uterine cavity assessment before in vitro fertilization

ObjectiveThis comparative study was designed to assess the role of saline infusion hysterosonography in refining the diagnosis of uterine cavity abnormalities diagnosed by hysteroscopy in infertile, asymptomatic women before in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) treatment.MethodsOne hundred and twenty four asymptomatic infertile women were included in this study before IVF/ICSI treatment. Hysteroscopy was done as routine procedure for uterine cavity assessment before the first attempt of IVF/ICSI treatment. Patients agreed to have an ultrasound assessment of uterine cavity with the use of saline as the contrast medium (Saline infusion hysterosonography, SIHS) beside the hysteroscopic assessment. Both hysteroscopy & SIHS procedures were scheduled post menstrual period in the early-mid follicular phase of a cycle of the same menstrual cycle, 1–3 months before starting the IVF/ICSI treatment.ResultsThe uterine cavity abnormalities were detected in 40.3% of the patients included in this study before IVF/ICSI treatment (17.7% endometrial polyps, 10.5% sub-mucous fibroid, 4.8% uterine septum, 3.2% uterine adhesions, 2.4% endometrial hyperplasia and 1.6% thin or atrophic endometrium). In this study, the hysteroscopy was more sensitive (98.0% versus 96.2%), more specific (100.0% versus 98.7%) and more accurate (99.2% versus 97.6%) than SIHS, and the hysteroscopy also had higher predictive values (100% versus 98% positive predictive value; 98.7% versus 97.4% negative predictive value) than SIHS during uterine cavity assessment before IVF/ICSI treatment.ConclusionsInfertile asymptomatic women should be screened for possible uterine cavity abnormalities before IVF/ICSI; SIHS is a simple, well tolerated procedure that can be used as a complementary tool to confirm the diagnosis of uterine cavity abnormalities detected by hysteroscopy.     

Effects of dietary proteins and trypsin inhibitor on growth and lipid metabolism in hamsters

The purpose of this study was to determine trypsin inhibitor (TI) activity in sweetpotato and soy flour diets and their effects on the growth and lipid metabolism of hamsters. Male Golden Syrian hamsters were fed different types of dietary protein containing casein, soyprotein, transgenic sweetpotato plus soy flour (TSPF+SF), nontransgenic sweetpotato (NTSPF) plus soy flour (NTSPF+SF), transgenic sweetpotato (TSPF) and nontransgenic sweetpotato flour for 28 days. The TI activity was highest in TSPF+SF (19.30 TIU/mg) and NTSPF+SF (17.20 TIU/mg) diets that induced growth retardation in animals, lowest in TSPF (5.80 TIU/mg) and NTSPF (5.50 TIU/mg) diets, which did not affect the growth of the animals, and negligible in casein (<1.00 TIU/mg) and soyprotein (2.00 TIU/mg) diets. Plasma total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) and triglyceride (TG) concentrations were significantly higher in hamsters fed the casein diet compared to those fed the soy protein, TSPF+SF, NTSPF+SF, TSPF and NTSPF diets. A positive correlation was observed between plasma TC concentrations of hamsters and dietary methionine, lysine, leucine content and methionine/glycine ratios. Liver TC and TG concentrations of hamsters fed casein were significantly higher than those of all other diet groups. The supplementation of sweetpotato flour with soy flour increased both protein and TI activity in the diets and the lipid metabolism of hamsters were unaffected by TI activity.     

腹腔镜联合醋酸亮丙瑞林对子宫内膜异位症合并不育症疗效

目的:探讨腹腔镜联合醋酸亮丙瑞林治疗子宫内膜异位症(EMS)合并不育症对患者妊娠结局的影响。方法:选取2017年3月-2019年3月本院收治的80例EMS合并不育症患者,随机分为对照组(n=40)和观察组(n=40),对照组给予腹腔镜治疗,观察组给予腹腔镜联合醋酸亮丙瑞林治疗,比较两组临床疗效、绝经症状(Kupperman)评分、盆腔疼痛程度(VAS)评分、血清学指标以及1年内复发率和妊娠率。结果:治疗后观察组治疗有效率(95.0%)高于对照组(67.5%),Kupperman(5.80±2.11分)、VAS评分(1.59±0.22分),低于对照组(8.52±3.84分、2.04±0.51分),血清卵泡刺激素、黄体生成素、雌二醇、基质金属蛋白酶-9、基质金属蛋白酶抑制剂-1、人附睾蛋白、糖类抗原125、糖类抗原199水平均低于对照组(均P<0.05),1年复发率(5.0%)低于对照组(25.0%),1年受孕率(45.0%)高于对照组(20.0%)(P<0.05)。结论:腹腔镜联合醋酸亮丙瑞林治疗EMS合并不育症疗效显著,可缓解临床症状和疼痛程度,改善性激素水平,降低复发率,提高受孕率。     

Conjugated linoleic acid reduces early aortic atherosclerosis greater than linoleic acid in hypercholesterolemic hamsters

Thirty-six male F₁B hamsters, 10 weeks of age, were divided into 3 groups of 12 based on similar body weights. The experimental diets comprised of a chow-based hypercholesterolemic diet supplemented with 20% coconut oil, 2% safflower oil, and 0.12% cholesterol (HCD); the HCD plus either 1% CLA as the free fatty acid (CLA), or 1% LA as the free fatty acid (LA) and were fed for 12 weeks. Plasma total cholesterol (TC) and nonHDL-C (very low- and low-density lipoprotein cholesterol) were significantly lower in the CLA and LA relative to the HCD (P < 0.05). The CLA had significantly less maximum number of dienes formed relative to the LA and HCD (P < 0.05). The CLA developed significantly less early aortic atherosclerosis relative to both the HCD and LA (P < 0.05). Thus it appears CLA reduces the development of early aortic atherosclerosis to a greater degree than LA possibly through changes in LDL oxidative susceptibility in hypercholesterolemic hamsters.