卵巢癌组织中错配修复蛋白MLH1的表达及临床意义

目的:观察卵巢癌组织中错配修复蛋白Mut L同系物1(MLH1)表达水平,探讨其与卵巢癌患者临床病理特征的关系,并分析MLH1与细胞增殖相关核抗原Ki-67表达的相关性。方法:选择71例卵巢癌组织、28例卵巢交界性肿瘤组织及20例正常卵巢组织作为研究对象,用免疫组织化学染色评分标准评价分析MLH1缺失与卵巢癌组织学类型、淋巴结转移情况、临床分期以及与Ki-67表达的相关性。结果:在71例卵巢癌组织中MLH1缺失率为14.1%;在卵巢交界性肿瘤组织及正常卵巢组织中无MLH1缺失现象(P<0.05);随肿瘤临床分期的升高,MLH1的缺失率显著降低(P<0.05),但其与肿瘤组织学类型、淋巴结转移无明显关系。在Ki-67低表达组中MLH1缺失占28.00%,在Ki-67高表达组中占6.52%(P<0.05),MLH1缺失与Ki-67表达呈负相关(r=-0.295,P=0.013)。结论:与卵巢交界性肿瘤及正常卵巢组织相比,MLH1缺失率在卵巢癌中明显升高,且随着卵巢癌临床分期的升高而降低。同时与卵巢病理诊断指标Ki-67具有相关性。     

GILZ和Ki-67在上皮性卵巢癌中的表达及其临床意义研究

目的 探讨GILZ和Ki-67在上皮性卵巢癌中的表达及其临床意义。方法 采用免疫组化SP法对大连医科大学附属第二医院2006-2012年收治的12例正常卵巢组织、19例卵巢良性肿瘤组织及45例上皮性卵巢癌组织标本进行GILZ和Ki-67蛋白表达检测,分析GILZ与Ki-67之间的相关性,并进行相关临床因素分析。结果 （1）GILZ、Ki-67在上皮性卵巢癌中的表达率（57.78%,46.67%）明显高于其在正常卵巢组织和卵巢良性肿瘤组织中的表达率（0,0;0,15.79%）(P<0.05)。（2）GILZ和Ki-67的表达与年龄、组织类型、临床分期、淋巴转移、腹水及化疗疗效均无相关性（P>0.05)。（3）GILZ与Ki-67的表达呈正相关。结论 （1）GILZ和Ki-67在上皮性卵巢癌中的表达明显高于正常卵巢组织和卵巢良性肿瘤组织,提示GILZ和Ki-67在卵巢癌的发生发展中可能扮演重要角色。（2）GILZ表达的增加可导致细胞增殖的增加,其高表达水平可以作为判断卵巢癌恶性程度、病情进展的重要指标。（3）联合检测GILZ和Ki-67对肿瘤的临床诊断、治疗及预后会有一定参考价值。     

促性腺激素释放激素及其受体在上皮性卵巢癌中的表达及临床意义

目的:探讨上皮性卵巢癌组织中促性腺激素释放激素GnRH及其受体GnRH-R的表达,及其与临床病理参数及细胞增殖标记物Ki-67的关系。方法:免疫组化法检测42例上皮性卵巢癌和38例上皮性良性卵巢肿瘤组织中Ki-67、GnRH及GnRH-R表达。结果:GnRH及GnRH-R主要表达于上皮性卵巢癌细胞胞浆,上皮性卵巢癌组织中GnRH及GnRH-R表达阳性率均高于良性卵巢组织(P0.01)。上皮性卵巢癌组织中GnRH阳性表达率与病理分级、手术分期有关(P0.05),与年龄无关(P0.05);GnRH-R阳性表达率与上皮性卵巢癌病理分级有关(P0.05),与手术分期及年龄无关(P0.05)。GnRH阳性卵巢癌组织的Ki-67计数为(35.36±23.21)%,显著低于GnRH阴性卵巢癌组织[(72.86±12.04)%](P0.01);GnRH-R阳性卵巢癌组织的Ki-67计数为(34.09±27.59)%,显著低于GnRHR阴性卵巢癌组织[(63.00±15.93)%](P0.01)。结论:上皮性卵巢癌中存在GnRH、GnRH-R过度表达,其表达与病理分级、手术分期及细胞增殖标记物Ki-67密切相关,提示GnRH可能抑制上皮性卵巢癌细胞的增殖和分化。     

卵巢上皮性癌组织及血清中MICA的表达和含量及临床意义

目的:检测卵巢上皮性癌组织及血清中主要组织相容性复合体相关蛋白A(MICA)的表达和含量,探讨其与卵巢上皮性癌细胞分化程度、组织学类型、临床分期的关系及临床意义.方法:免疫组化SP法检测卵巢上皮性癌(59例)及卵巢上皮性良性肿瘤组织(12例)、正常卵巢上皮组织(15例)膜型主要组织相容性复合体相关蛋白A (mMICA)的表达;ELISA法检测卵巢上皮性癌、卵巢上皮性良性肿瘤及健康人(15例)血清可溶性主要组织相容性复合体相关蛋白A(sMICA)的含量.结果:①mMICA在卵巢上皮性癌和卵巢上皮性良性肿瘤组织表达阳性率分别为72.88％、8.33％,差异有高度统计学意义(P＜0.01).在卵巢上皮性癌低分化组和中分化组表达阳性率分别为90.48％、63.16％,Ⅰ～Ⅱ期组和Ⅲ～Ⅳ期组表达阳性率分别为45.45％、79.17％,差异均有统计学意义(P＜0.05).在正常卵巢上皮组织不表达.②血清中sMICA含量,卵巢上皮性癌20.79±8.37 ng/ml、卵巢上皮性良性肿瘤9.98±1.75 ng/ml、健康人6.47±1.69 ng/ml,差异有高度统计学意义(P＜0.01).在卵巢上皮性癌低分化组含量高于中分化组,Ⅲ～Ⅳ期组高于Ⅰ～Ⅱ期组,差异有统计学意义及高度统计学意义(P ＜0.05,P＜0.01).③在卵巢上皮性癌不同组织学类型的卵巢上皮组织中mMICA的表达阳性率及血清中sMICA含量比较,差异均无统计学意义(P＞0.05).结论:卵巢上皮性癌组织mMICA表达阳性率及血清中sMICA含量均较高,且均与卵巢上皮性癌细胞分化程度、临床分期有关.检测血清sMICA含量可能作为辅助诊断及评价卵巢上皮性癌病情的一个指标.     

乙酰肝素酶mRNA在卵巢上皮性肿瘤中的表达及其临床病理相关性研究

目的探讨乙酰肝素酶（Hpa）mRNA在卵巢上皮性癌中的表达及与临床病理的相关性。方法应用逆转录-聚合酶链反应（RT-PCR）方法检测41例卵巢上皮性癌、17例卵巢良性肿瘤和22例正常卵巢组织中Hpa mRNA表达，并分析其与卵巢癌临床病理的相关性。结果①卵巢上皮性癌组织、良性肿瘤组织和正常组织Hpa mRNA阳性表达率分别为58．54％、29．41％和22．73％。癌组织Hpa mRNA阳性表达率显著高于良性组及正常组（P〈0．01），良性组与正常组Hpa mRNA阳性表达率比较，差异无显著性（P〉0．05）。②Ⅲ～Ⅳ期卵巢恶性肿瘤患者中Hpa mRNA的阳性表达率显著高于Ⅰ～Ⅱ期患者（P〈0．05）。低分化肿瘤组织中Hpa mRNA的阳性表达率显著高于中、高分化者（P〈0．05）。③Long-rank分析显示Hpa mRNA表达阳性者的累积生存率明显低于阴性者，差异有显著性（P〈0．05）。结论卵巢上皮性癌中Hpa mRNA阳性表达率明显增高，并与卵巢上皮性癌病情进展有关，可作为卵巢上皮性癌转移和预后的一个重要预测指标。     

NGAL和MMP-9在卵巢上皮性癌中的表达及相关性研究

目的:检测中性粒细胞明胶酶相关载脂蛋白(NGAL)和基质金属蛋白酶-9(MMP-9)在卵巢上皮性肿瘤组织和血清中的表达,了解两者与卵巢癌临床病理特征的关系。方法:应用半定量RT-PCR和ELISA法检测50例上皮性卵巢癌、21例卵巢良性肿瘤和18例正常对照的卵巢组织和血清中NGAL和MMP-9的表达水平。结果:(1)卵巢癌组的组织及血清中NGAL和MMP-9表达明显高于卵巢良性肿瘤组和正常对照组(P均<0.05);二者的高表达与临床分期、淋巴结转移正相关(P均<0.05);卵巢癌患者的组织及血清中NGAL与卵巢癌的组织分化程度正相关(P均<0.05),MMP-9则与卵巢癌的组织分化程度负相关(P均<0.05)。(2)卵巢癌患者的组织或血清中,NGAL表达均与MMP-9表达呈正相关(r=0.740,r=0.676,P均<0.05)。结论:NGAL和MMP-9在卵巢上皮性癌中表达上调,可能与卵巢上皮性癌的发生、发展有关。     

卵巢上皮性癌组织中磷酸化蛋白激酶B和PTEN蛋白的表达及其意义

目的探讨磷酸化蛋白激酶B（pAKT）和FYEN蛋白在卵巢上皮性癌（卵巢癌）组织中的表达及其相互关系,并分析两者与卵巢癌患者预后的关系。方法应用免疫组化法,检测12份正常卵巢、20份卵巢良性上皮性肿瘤、12份卵巢交界性上皮性肿瘤、80份卵巢癌组织中pAKT和PTEN蛋白的表达,并分析两者间的关系。采用单因素和多因素生存分析法分析pAKT和FYEN蛋白表达与卵巢癌患者预后的关系。结果pAKT蛋白在正常卵巢、卵巢良性上皮性肿瘤组织中的阳性表达率分别为8％、10％。显著低于卵巢癌组织的55％（P〈0．01）;而FYEN蛋白在卵巢癌组织中的阳性表达率为45％,显著低于正常卵巢和良性上皮性肿瘤组织的100％、80％（P〈0．01）。pAKT和FYEN蛋白在交界性肿瘤组织中的阳性表达率分别为25％、67％,分别与卵巢癌组织比较,差异均无统计学意义（P〉0．05）。pAKT和FYEN蛋白表达与卵巢癌手术病理分期、病理分级、有无淋巴结转移和远处转移有关（P〈O．05）,而与年龄、病理类型、有无腹水无关（P〉0．05）。卵巢癌组织中pAKT和PTEN蛋白间的表达呈明显负相关关系（r=-0．444,P〈0．01）。单因素生存分析显示,手术病理分期、病理分级、有无淋巴结转移和远处转移、pAKT和FrEN蛋白阳性表达与患者预后有关（P〈0．05）。Cox回归多因素分析表明,FYEN蛋白阳性表达和手术病理分期是影响卵巢癌患者预后的独立危险因素（P〈0．05）。结论pAKT蛋白过度表达伴随PTEN蛋白表达缺失可能参与卵巢癌的发生、发展,PTEN蛋白表达缺失是卵巢癌患者预后不良的独立危险因素。     

IMP1在上皮性卵巢癌中的表达及意义

目的:探讨上皮性卵巢癌组织中胰岛素样生长因子ⅡmRNA结合蛋白1(IMP1)蛋白及mRNA的表达与上皮性卵巢癌发生发展的关系。方法:采用免疫组化法和RT-PCR技术检测47例上皮性卵巢癌(恶性组)、28例上皮性卵巢良性肿瘤(良性组)及20例正常卵巢上皮组织(正常组)中IMP1蛋白和mRNA的表达情况,并分析IMP1蛋白表达与上皮性卵巢癌的临床病理特征的相关性。结果:上皮性卵巢癌、上皮性卵巢良性肿瘤及正常卵巢上皮组织中IMP1蛋白的阳性表达率分别为85.1%、32.1%和10%,IMP1mRNA相对表达量分别为0.652±0.067、0.120±0.014和0.085±0.011。卵巢癌组织中IMP1蛋白及mRNA表达量均显著高于正常组和良性组(P0.05),而后两组则无显著差异(P0.05)。上皮性卵巢癌组织中IMP1蛋白表达与FIGO分期和病理组织学分级有关(P0.05),而与有无腹水、淋巴结转移无关(P0.05)。结论:IMP1可能参与上皮性卵巢癌的发生发展过程。     

HIF-1α、iNOS和EPO在卵巢上皮性肿瘤组织中的表达变化及意义

目的 分析缺氧诱导因子-1α(hypoxia-inducible factor-1α, HIF-1α)、诱导型一氧化氮合酶（inducible nitric oxide synthase, iNOS）和促红细胞生成素（erythropoietin, EPO）在卵巢上皮性肿瘤组织中的表达变化及意义。方法 收集2017年8月至2020年12月于浙江省余姚市人民医院行手术切除并经病理证实的卵巢上皮性肿瘤和正常卵巢组织患者96例,其中正常卵巢组织患者21例（正常组）,良性肿瘤患者26例（良性组）,交界性肿瘤患者11例（交界组）,恶性肿瘤患者38例（恶性组）。分析HIF-1α、iNOS和EPO在不同卵巢组织中的表达变化以及各指标对卵巢癌的预测价值。结果 正常组、良性组、交界组、恶性组的HIF-1α、iNOS和EPO蛋白表达阳性率逐渐升高（P <0.05）,恶性组中不同临床分期、病理分级间HIF-1α、iNOS和EPO蛋白的表达差异均有统计学意义（P <0.05）,其中Ⅲ/Ⅳ期、中低分化卵巢癌阳性率更高。HIF-1α、iNOS、EPO蛋白单一及联合对卵巢癌的阳性预测值分别为61.70%...     

增殖细胞核抗原在上皮性卵巢肿瘤中的表达及其临床病…

应用免疫组织化学方法检测了５９例上皮性卵巢肿瘤中增细胞核抗原（ＰＣＮＡ）的表达，以探讨卵巢肿瘤中ＰＣＮＡ蛋白表达的临床病理意义，结果：ＰＣＮＡ在良，恶性上皮性卵巢瘤中均有表达，但卵巢癌中ＰＣＮＡ的阳性率（８０．９％）明显高于良性卵巢瘤中的阳性率（２５％，Ｐ〈０．０１），卵巢癌中，高分化卵巢癌ＰＣＮＡ的阳性指数评分低于中，低分化卵巢癌（Ｐ〈０．００１），ＰＣＮＡ阳性指数评分与分化程度之间呈负相关，ｒ     

Toll样受体与子宫内膜及子宫内膜异位症

子宫内膜异位症(EMs)发病机制尚未完全阐明.大量研究表明,免疫因素在EMs的发病机制中起重要作用.EMs免疫应答异常主要是巨噬细胞数量和活性增加及其分泌产物,如生长因子、细胞因子和血管生成因子的改变.Toll样受体(TLRs)识别特异性的病原体相关分子模式,启动和介导免疫应答,在固有免疫中发挥重要作用,并诱导产生适应性免疫反应.TLRs在正常子宫内膜中的生理作用以及在EMs中的相关研究已逐步开展,对其深人认识和研究将为EMs诊断、治疗和预后判断提供新思路和手段.     

Pharmacokinetics and endometrial and tubal tissue penetration of cefalotin and cefazolin

The pharmacokinetics and concentrations of the two antibiotics cefazolin and cefalotin were studied during gynecologic operations in endometrial and tubal tissue. The patients received 0.05 g/kg of the antibiotics by intravenous injection. Under the given conditions, pharmacokinetic calculation of the plasma elimination gave half-lives of 24.8 min for cefalotin and of 63 min for cefazolin. Fitting of the tissue levels to the Bateman function showed that the two antibiotics diffuse rapidly into both tubal and endometrial tissue and attain peak concentration levels between 10 and 25 min. In both tissues the concentrations of cefazolin were higher than those of cefalotin. Higher tissue concentrations of cefazolin could also be demonstrated in experiments of longer duration.     

Toll样受体与子宫内膜及子宫内膜异位症

子宫内膜异位症（EMs）发病机制尚未完全阐明。大量研究表明,免疫因素在EMs的发病机制中起重要作用。EMs免疫应答异常主要是巨噬细胞数量和活性增加及其分泌产物,如生长因子、细胞因子和血管生成因子的改变。Toll样受体（TLRs）识别特异性的病原体相关分子模式,启动和介导免疫应答,在固有免疫中发挥重要作用,并诱导产生适应性免疫反应。TLRs在正常子宫内膜中的生理作用以及在EMs中的相关研究已逐步开展,对其深入认识和研究将为EMs诊断、治疗和预后判断提供新思路和手段。     

Israeli and British women's wellbeing and eating behaviours in pregnancy and postpartum

Objectives: The study had two main objectives: (a) track changes in self-esteem, eating behaviours and body satisfaction from early pregnancy to 24 months postpartum and (b) to compare changes by context (Israel vs. UK) and maternal body mass index (BMI).

Background: High maternal BMI is associated with negative body image and restrained eating, which are experienced differently across cultures.

Methods: 156 pregnant women were recruited from Israel and the UK. Seventy-three women were followed up every six months from early postpartum and until 24 months following birth. Women completed questionnaires assessing self-esteem (RSEQ), body image (BIS/BIDQ) and eating behaviours (DEBQ) and self-reported weights and heights so that BMI could be calculated.

Results: Women with higher BMI had higher levels of self-esteem and were less satisfied with their body. Healthy-weight women were more likely to lose all of their retained pregnancy weight compared to overweight and obese women. Self-esteem, body image and eating behaviours remained stable from pregnancy until 24 months postpartum. No significant differences were found for any measure by context.

Conclusion: BMI was the strongest predictor of self-esteem and body dissatisfaction and a higher BMI predicted less weight loss postpartum.     

Psychological and pharmacological treatments of mood and anxiety disorders during pregnancy and postpartum. Review and synthesis

The aim of this article is to review the main methods of treatment of anxious and depressive disorders during pregnancy and the postpartum. To this end, we analyse recent publications about the use and efficacy of psychotherapy and psychosocial interventions (cognitive behavioural therapy, interpersonal psychotherapy, psychoanalytical therapy) in the perinatal period. We also review recent papers about the use of psychotropic medication during pregnancy and breast-feeding, with special emphasis on clinical trials. We particularly focus on the risk/benefit assessment of antidepressants, mood stabilisers, antipsychotics and benzodiazepines, in terms of teratogenicity, and impact on neonatal adaptation and neuropsychological development. Various treatment modalities are presented and discussed. It appears that psychotherapies have proved their efficiency on most pre- and postpartum anxious and depressive disorders and represent a first line treatment in most cases. Psychopharmacological treatment is indicated for severe anxious and depressive disorders. The risks of such medication, especially antidepressants, may have been overestimated in the past. Provided reasonable precautions are taken and mothers and future mothers receive clear information on the potential risks and benefits, psychotropic medication could be more broadly prescribed during pregnancy and the breast-feeding period.     

Placental ischemia and changes in umbilical and uteroplacental arterial and venous hemodynamics

Objective: To relate Doppler velocimetry findings in fetoplacental and uteroplacental circulation to placental histomorphology. Material and methods: In 14 uncomplicated and 31 high-risk pregnancies Doppler velocimetry was performed in umbilical artery and vein, and in maternal uterine veins and arteries during the second half of gestation. Histopathology of the placentas was examined, especially for signs of ischemia and inflammation. Results: All fetuses in uncomplicated pregnancies had normal flow velocity waveforms in umbilical artery; in the high-risk group, 18 fetuses had abnormal flow (increased PI or absent/reverse end-diastolic flow). The latter group had more often high ischemic score and infarctions in the placenta than found in pregnancies with normal umbilical artery flow (p?<?0.001 and p?=?0.02, respectively). Similarly, the abnormal uterine artery flow pattern (uterine artery score 3–4) occurred more often with high ischemic score and placenta infarctions (p?<?0.001 and p?<?0.001, respectively). No significant associations were found between the uterine venous flow type and placental ischemia. Conclusion: Placental ischemic morphological changes were associated with Doppler ultrasound signs of increased resistance to arterial blood flow, both on the fetal and maternal sides of the placenta. No significant relation to the uterine venous flow velocities was found.     

绒毛膜羊膜炎与胎儿及新生儿疾病

绒毛膜羊膜炎是产科炎症反应,但与新生儿预后关系密切。母体的宫内炎症反应可以直接导致胎儿和婴儿患病率和死亡率增加,胎儿炎症反应综合征（FIRS）也不可忽视。早期识别和快速诊断有助于减少母儿的近期合并症,改善新生儿的远期预后。产科和儿科共同关注,整合信息,是早期发现、实施有效干预的临床重点之一。