子宫内膜异位症肿瘤坏死因子α(TNF-α)的意义

子宫内膜异位症(简称内异症)的病因和发病机理迄今不明。近10年研究结果表明,腹腔液中多种活性物质可能在其发生过程中有决定性意义。 对74例内异症患者腹腔液中的肿瘤坏死因子α(TNF-α)进行测定,并分3组:陈旧性或无活性腹膜内异症组(27例),鲜红色、活性内异症组(34例)和重度广泛性内异症组,即rAFS Ⅲ、Ⅳ期患者(13例)。另20例腹腔镜检查无异常者为对照组。     

Platelet-derived growth factor receptor alpha (PDGFRα) targeting and relevant biomarkers in ovarian carcinoma

Objective

Platelet-derived growth factor receptor alpha (PDGFRα) is believed to be associated with cell survival. We examined (i) whether PDGFRα blockade enhances the antitumor activity of taxanes in ovarian carcinoma and (ii) potential biomarkers of response to anti-PDGFRα therapy.

Methods

PDGFRα expression in 176 ovarian carcinomas was evaluated with tissue microarray and correlated to survival outcome. Human-specific monoclonal antibody to PDGFRα (IMC-3G3) was used for in vitro and in vivo experiments with or without docetaxel. Gene microarrays and reverse-phase protein arrays with pathway analyses were performed to identify potential predictive biomarkers.

Results

When compared to low or no PDGFRα expression, increased PDGFRα expression was associated with significantly poorer overall survival of patients with ovarian cancer (P = 0.014). Although treatment with IMC-3G3 alone did not affect cell viability or increase apoptosis, concurrent use of IMC-3G3 with docetaxel significantly enhanced sensitization to docetaxel and apoptosis. In an orthotopic mouse model, IMC-3G3 monotherapy had no significant antitumor effects in SKOV3-ip1 (low PDGFRα expression), but showed significant antitumor effects in HeyA8-MDR (high PDGFRα expression). Concurrent use of IMC-3G3 with docetaxel, compared with use of docetaxel alone, significantly reduced tumor weight in all tested cell lines. In protein ontology, the EGFR and AKT pathways were downregulated by IMC-3G3 therapy. MAPK and CCNB1 were downregulated only in the HeyA8-MDR model.

Conclusion

These data identify IMC-3G3 as an attractive therapeutic strategy and identify potential predictive markers for further development.     

Microparticle subpopulations are increased in preeclampsia: possible involvement in vascular dysfunction?

OBJECTIVE: The purpose of this study was to investigate the cellular origin and numbers of circulating microparticles in normal pregnancy and preeclampsia. STUDY DESIGN: Plasma samples from 10 women with preeclampsia, from 10 normal pregnant women, and from 10 nonpregnant women matched for age and gestation, were analyzed by flow cytometry. RESULTS: The total number of circulating microparticles was unaltered in pregnancy and preeclampsia. The largest portion of microparticles was derived from platelets in all groups. T-suppressor cell microparticle numbers were decreased in normal pregnancy (P =.04). In preeclampsia T-suppressor, T-helper cell, and granulocyte microparticle numbers were increased (P =.008,.008, and.03, respectively). Elastase concentrations were increased in preeclampsia (P =.02) and correlated with granulocyte microparticle numbers (P =.006). Elastase concentrations correlated with systolic and diastolic blood pressure (P =.001 and.003, respectively), and granulocyte microparticle numbers correlated with systolic blood pressure (P =.05). CONCLUSION: Numbers of T-cell and granulocyte microparticles are increased in preeclampsia. Whether these altered microparticle numbers cause vascular dysfunction in preeclampsia or are a consequence of the disease remains to be established.     

前列腺素F_(2α)用于葡萄胎引产

作者自1971年12月至1972年10月观察6例葡萄胎应用静脉滴注前列腺素F_(2α)引产,以后许多临床报道对足月妊娠,特别对早期及中期妊娠用前列腺素引产也有效。例1:24岁初孕妇,妊娠21周合并妊娠中毒症,子宫约妊娠29周大小,少量阴道出血,无胎动,12小时绒毛促性腺激素(HCG)排出量为10,000,000—12,000,000单位,超声波呈典型葡萄胎波型,确诊为葡萄胎。前列腺素F_(2α)溶于1毫升生理盐水中,开始50微克/分静滴4 1/2小时,继之100微克/分再静滴8小时。注射开始后30分钟出现有规     

Successful pregnancy outcome in Ehlers–Danlos syndrome,vascular type

Background.?Ehlers–Danlos syndrome (EDS) is a rare connective tissue disorder characterized by tissue fragility, translucent skin and joint hypermobility. Patients with the vascular type of EDS are prone to spontaneous arterial and visceral rupture. Pregnancy for women with vascular EDS can be life-threatening. Mortality rates are high due to the increased risk for uterine and arterial rupture in the peripartum period.

Case.?We describe the counseling, multidisciplinary management, protocol, and successful pregnancy outcome of a 32-year-old woman with vascular EDS.

Conclusion.?There is no consensus in the literature on the timing and mode of delivery for pregnant women with vascular EDS. The management undertaken in our patient may assist others in optimizing the perinatal outcome in other women who elect to continue their pregnancy despite the risks of this severe medical condition.     

静脉滴注合成前列腺素F_(2α)终止妊娠

应用前列腺素E_2或F_(2α)引产及人工流产已有广泛报道。不论何种给药途径,其成功率稍低于100％,但其副作用发生率均很高。希望合成前列腺素F_(2α)有较好引产效果,同时并能降低其副作用。     

Uncommon vascular tumor of the ovary. Primary ovarian epithelioid hemangioendothelioma or vascular sarcomatous transformation in ovarian germ cell tumor?

Epithelioid hemangioendothelioma (EHE) is an unusual vascular tumor, which usually occurs in the soft tissue, liver, breast, lung and bone. We submit a case of EHE, a tumor never before reported in the ovary. A 20-year-old woman was admitted with a medical history of unilateral ovarian tumor. The right ovary was totally removed and histologically, the tumor was composed of epithelioid cells with eosinophilic cytoplasm and prominent intracytoplasmic vacuoles associated with myxohyaline matrix. No morphologic evidence of germ cell tumor was observed. Immunohistochemically, the tumor cells were positive for CD31 and CD34. However, all germ cell tumor markers were negative. The final diagnosis was EHE of the ovarian gland and sarcomatous transformation in ovarian germ cell tumor was excluded after extensive histopathological and immunohistochemical study. EHE is an uncommon vascular tumor, which is rarely seen in female genital tract and this is the first report of EHE in ovarian gland. Final diagnosis depends on histopathological and immunohistochemical features.     

The vascular endothelial growth factor (VEGF) +405 G/C polymorphism and its relationship with recurrent implantation failure in women in an IVF programme with ICSI

Purpose

Successful embryo implantation depends on trophoblast proliferation, migration and, lastly, invasion of the endometrium (to anchor the trophoblast to the uterus). This invasion is mediated by locally produced soluble factors. Of these, vascular endothelial growth factor (VEGF) is the best characterized regulator of angiogenesis. Here, we investigate the association between the VEGF + 405 C/G genotype and the recurrence of embryo implantation failure in women undergoing in vitro fertilization (IVF) program with intracytoplasmic sperm injection (ICSI).

Methods

Forty women with recurrent implantation failure defined by absence of pregnancy after transfer of more than 10 embryos and 131 women control, with at least one live birth after the transfer of fewer than 10 embryos were included. Genomic DNA was analysed with an allele-specific polymerase chain reaction and a Chi-2 test was used to compare the respective VEGF + 405 C/G genotype frequencies in cases and controls.

Results

The frequency of the VEGF +405C/C genotype was higher in women with recurrent implantation failure after ICSI-embryo transfer than in controls (17.5 % and 5.3 %, respectively, p = 0.01).

Conclusion

The VEGF +405 G/C polymorphism may influence embryo implantation and VEGF + 405 C/C genotype may predispose to recurrent implantation failure after ICSI-ET.     

Does vascular endothelial growth factor participate in uterine myoma growth stimulation?

Objective

Peptide growth factors play a role in the rebuilding of extracellular matrix in the course of leiomyoma growth, and exert a regulative effect on the cell only when they bind with a specific membrane receptor and transmit a signal into the cell. A high content of certain peptide growth factors and their receptors in leiomyoma suggests that in the course of the tumour growth hyperstimulation of cells takes place. A combined action of various peptide growth factors causes an amplification of signal paths in cells, inducing gene expression of proteins responsible for cell division and changes of metabolism. We therefore decided to evaluate the amounts and expression of VEGF, their receptor and mRNA levels.

Study design

Studies were performed on human myometrium and uterine leiomyomas of various weights (small: i.e. less than 10 g, and large: i.e. more than 100 g). Expression and content of VEGF-A, D and VEGF R-1, R-2 were analysed with Western blot and ELISA methods, respectively. The RT-PCR method was used to determine VEGF mRNA levels.

Results

Our immunoblotting studies and immunoenzymatic assay, as well as RT-PCR technique, did not detect significant differences in the expression of VEGFs and their receptors in control myometrium and in uterine leiomyomas.

Conclusion

The increase in the amount of some peptide growth factors, especially FGFs and IGF-I, in large leiomyomas without any change in VEGF content means a decrease in the proportional relationship of the latter to other growth factors. Stimulation of extracellular matrix formation seems stronger than angiogenesis during myoma growth.     

Expression of the inhibin/activin subunits alpha (α), beta-A (βA) and beta-B (βB) in benign human endometrial polyps and tamoxifen-associated polyps

Background Inhibins (INH) are dimeric glycoproteins, composed of an alpha subunit (INH-) and one of two possible beta subunits (INH-A or INH-B). They have substantial roles in human reproduction and in endocrine-responsive tumours. Therefore, the aims of this study were to determine the frequency and tissue distribution of INH-, INH-A and INH-B in normal human endometrium and glandular-cystic endometrial polyps, and polyps caused by tamoxifen use.Materials and methods Tissue samples were obtained from women in the proliferative, early secretory and late secretory phase as well as glandular-cystic polyps and endometrial polyps associated with tamoxifen use (n=5 each). Immunohistochemistry with specific monoclonal antibodies, a semi-quantitative analysis and statistical evaluation was performed.Results INH-, INH-A and INH-B were primarily observed in glandular and luminal epithelial cells, with a variant staining intensity in stromal cells. INH- in glands was significantly higher during the early secretory phase (p<0.05) and the late secretory phase (p<0.01) than in the proliferative phase with a significant difference between the early secretory and the late secretory phases (p<0.01). INH-A expression was significantly higher during the late secretory than the proliferative phase (p<0.05) and the late secretory than the early secretory phase (p<0.05), with no significant differences for INH-B. Glandular-cystic polyps showed significantly lower expression of INH- and INH-A than the late secretory endometria (p<0.05 and p<0.01 respectively). Additionally, tamoxifen-associated polyps also demonstrated a significantly lower expression of INH- and INH-A than late secretory endometria (p<0.01 and p<0.01 respectively). No statistical differences were observed between tamoxifen-associated and glandular-cystic polyps.Discussion INH-, INH-A and INH-B were expressed in normal endometrium and endometrial polyps. A cyclical expression of INH- and INH-A in normal glands may reflect a functional and hormone-dependent role in human endometrium. Significant differences in staining reaction between the late secretory endometria and polyps suggest that this tissue remains in the proliferating state rather than the secretory state. Therefore, endometrial polyps may be tumours of dysregulation with mainly proliferating characteristics, being unable to synchronise with normal endometrium.     

奥平(α-干扰素栓)治疗宫颈糜烂60例

奥平（α—干扰素栓）治疗宫颈糜烂６０例刘其芬冯丽光潘丽华近１０年经大量流行病学调查资料提示，宫颈炎和宫颈癌的发生与单纯疮疹病毒（ＨＳＶ）和乳头瘤病毒（ＨＰＶ）感染密切相关〔１，２〕，因此，寻找治疗宫颈炎、预防宫颈癌的抗病毒制剂是摆在广大医务工作者面前...     

PGF_(2α)对人绒毛膜促性腺激素(HCG)促进人黄体生成孕酮的影响

PGF_(2α)直接注射于黄体可使孕酮迅速降低。由于对人体内研究的限制,本实验采用离体技术阐明PGF_(2α)的作用。16名29～50岁的妇女,月经期规律(26～30天),妇科手术中获得卵巢。依据子宫内膜组织学和月经史来决定取得的黄体周期。月经的第十六至十九天、二十至二十二天和二十三至二十七天分别为早、中、晚黄体期。以 HCG 促进黄体生成孕酮和孕酮的基础分泌来评价 PGF_(2α)的作用。将黄体切成小片,随机分成9组,分放于9个培养管中。第一管含2ml 0.9%盐水,于-20℃保存,待测定内源性孕酮含量。第二至九管含 pH7.4     

正常人和下丘脑垂体功能失调患者中α-黑素细胞刺激素(α-MSH)促使促性腺激素(Gn)释放的作用

本文研究对象为26例正常人(月经规划妇妇15例、绝经后妇女5例、男性6例)和20例下丘脑垂体功能失调患者。对月经规则妇女分别在周期各期进行研究:卵泡早期(EF)6例、卵泡晚期(LF)     

子(疒间)前期孕妇血浆8-异前列腺素F_(2α)的变化

子(疒间)前期(preeclampsia)是妊娠期高血压疾病的严重阶段,其病因及发病机制未完全阐明,近年来氧化应激学说在该病的发病机制中占有越来越重要的地位.8-异前列腺素F_(2α)(8-iso-prostaglandin F_(2α),8-iso-PGF_(2α))水平是一个可靠和稳定的氧化应激标记物.本研究通过测定8-iso-PGFF_(2α)水平在子(疒间)前期患者血浆的表达变化,了解子(疒间)前期患者的脂质过氧化水平.     

宫体注射PGF_(2α)预防和治疗严重产后出血(47例临床分析)

产后出血是产科常见的严重并发症,1980年全国妇产科学术会议指出,产后出血是孕产妇死亡的首要原因,而宫缩乏力出血又是产后出血的主要原因,重则导致出血性休克,使产妇濒于死亡。因此迫切需要寻求一种迅速而有效的控制严重产后出血的方法。我院自1981年1月到1984年1月,经宫体或宫颈注射PGF_(2α)治疗经各种治疗方法无效的宫缩乏力性出血47例。兹介绍如下。对象和方法一、对象:经阴道分娩产后出血达400ml以上,或剖宫产分娩产后出血达500ml以上,经各种治疗方法     

Whole ovary cryopreservation with vascular transplantation – A future development in female oncofertility

Preservation of female fertility in female cancer victims is gaining more importance in the light of the excellent survival rates today after treatment for the types of cancer, which are common in women during childhood and fertile age. In this article we discuss the risks of infertility after various cancer treatments and in what patient categories fertility preservation should be discussed. The modes of female fertility preservation used today as clinically established methods or as experimental methods that are used in the human female are reviewed. The advantages and disadvantages of the methods are also identified. Whole ovary cryopreservation has been suggested as a possible future more efficient method of fertility preservation. The research on this method in different animal models is discussed in detail and unsolved questions are identified. To date there has not been any attempt to transplant a cryopreserved whole human ovary but human ovaries have already been cryopreserved for future fertility preservation purposes, when cryobiological and microsurgical techniques have been further refined.     

用PGF_(2α)类似体ICI81008诱发月经

ICI81008(Ⅰ)是英国新近合成的一个具有强溶黄体作用的前列腺素新品种。系PGF_(2α)类似体,结构式如图。在大鼠的实验中,其终止妊娠作用远远超过天然的PGF_(2α)和E_2。本文报道其抗早孕的临床结果。     

前列腺素F_(2α)对早孕子宫颈的扩张作用

目的:探讨前列腺素F2α对宫颈的扩张作用。方法:采用前瞻性、随机分组、双盲对比研究,分析0.5 mg卡孕栓在负压吸宫时的临床效果、雌孕激素受体表达和超微结构变化。结果:给药后,观察组宫颈内口松弛,组间差异显著,扩宫时的疼痛感明显轻于对照组(P<0.05)。免疫组化分析,观察组雌孕激素受体表达未见增高。电镜下,观察组成纤维细胞及胶原蛋白均有显著改变。结论:0.5 mg卡孕栓能促进宫颈胶原溶解,抑制胶原合成,有效扩张早孕宫颈内口,减轻扩宫疼痛。阴道给药在有效扩张早孕宫颈内口的同时,可以显著减少胃肠道副反应的发生。