黄体功能不全患者着床期子宫内膜雌孕激素受体的表达及超微结构改变

目的 :探讨黄体功能不全 (L PD)不孕患者和正常育龄妇女着床期子宫内膜雌、孕激素受体的表达及超微结构改变。方法 :应用单克隆免疫组织化学技术分别对 8例组织学诊断 L PD的不孕妇女和 13例健康育龄妇女尿 L H峰出现后 6～ 10 d子宫内膜雌激素受体 (ER)及孕激素受体 (PR)的表达进行检测 ,同时在扫描电镜 (SEM)下观察两组着床期子宫内膜超微结构特点。结果 :L PD患者着床期子宫内膜腺上皮 PR、 ER和间质 ER表达水平均较正常对照组显著增高 (分别为 P<0 .0 1,P<0 .0 5 ,P<0 .0 5 ) ;扫描电镜下观察 L PD组子宫内膜细胞胞膜转换延迟 ,胞饮小泡发育滞后于正常对照组 2 d以上。结论 :L PD患者子宫内膜组织学上的成熟延迟与内膜 ER、 PR降调失败密切相关 ,延迟开放的着床窗和受损的内膜容受性影响了胚胞的着床 ,是导致L PD不孕的重要原因     

Bcl—2基因家族及雌,孕激素受体与黄体功能不全

Ｂｃｌ－２基因家族是一族调控细胞调亡的基因，在生物有机体的正常生理调节和病理过程中发挥重要的作用。研究证明，Ｂｃｌ－２基因家族在正常子宫骨膜中的表达随月经周期发生变化，并与雌、孕激素受体的变化有关。黄体功能不全患者子中内膜雌、孕激素受体表达异常。综述Ｂｃｌ－２基因家族及雌、孕激素受体与黄体功能不全的研究进展。     

Bcl-2基因家族及雌、孕激素受体与黄体功能不全

Bcl-2基因家族是一族调控细胞凋亡的基因,在生物有机体的正常生理调节和病理过程中发挥重要的作用。研究证明,Bcl-2基因家族在正常子宫内膜中的表达随月经周期发生变化,并与雌、孕激素受体的变化有关。黄体功能不全患者子宫内膜雌、孕激素受体表达异常。综述Bcl-2基因家族及雌、孕激素受体与黄体功能不全的研究进展。     

孕激素阻断子宫内膜癌前病变癌变雌孕激素受体的测定

目的 :孕激素治疗子宫内膜癌前病变 ,使其转变为正常内膜 ,测定治疗前后子宫内膜雌激素受体和孕激素受体 (ER.PR) ,以了解子宫内膜改变时 ,ER.PR的变化情况。方法 :对 32例癌前病变内膜孕激素治疗前后的石蜡切片 ,采用单克隆抗体免疫组化法测定子宫内膜 ER.PR。结果 :孕激素治疗后 ,子宫内膜由腺瘤样增生或非典型性增生逆转为正常内膜 ER.PR下降 ,前后有显著性差异 (P<0 .0 5 )。结论 :孕激素可有效的阻断子宫内膜癌前病变的恶变 ,并使其逆转为正常内膜 ,同时使子宫内膜 ER.PR下调。     

克罗米酚和绒毛膜促性腺激素对种植窗期子宫内膜雌孕激素受体的影响

目的　认识及评价克罗米酚 (CC)与绒毛膜促性腺激素 (HCG)对种植窗期子宫内膜雌激素受体 (ER)、孕激素受体 (PR)水平的影响。　方法　 30例生育期妇女于月经周期第 5～ 9d口服CC 5 0mg/d;2 7例口服CC 5 0mg/d,在B超监测下当优势卵泡≥ 18mm时 ,肌肉注射HCG5 0 0 0单位 ,以注射当日定为LH第 0天 ,对照组不服CC ,不注射HCG ,以阴道B超及尿黄体生成素(LH)试纸监测排卵情况 ,并测定子宫内膜ER、PR。　结果　对照组子宫内膜成熟延迟发生率为2 9 0 3% (9/ 31) ,CC组子宫内膜成熟延迟发生率为 5 6 6 7% (17/ 30 ) ,2组比较差异有显著性 (P <0 0 5 ) ;CC降低了种植窗期子宫内膜间质、腺体及总体PR的含量 ,与对照组比较差异有显著性 (P <0 0 5 ) ;HCG使种植窗期子宫内膜PR含量有降低趋势。　结论　CC导致子宫内膜成熟延迟的发生率增加 ,其原因可能与降低种植窗期子宫内膜PR含量有关 ;HCG的使用可能会同时影响内膜的正常环境 ,对种植不利 ,但还需进一步探讨。     

子宫内膜异位症组织趋化因子及雌孕激素受体表达变化

目的探讨子宫内膜异位症组织趋化因子及雌孕激素受体表达的变化情况。方法选取2015年1月-2016年12月期间长兴妇幼保健院所收治的88例子宫内膜异位症患者为观察组,另选取86例同期在医院进行健康体检者作为对照组,并对两组患者的组织趋化因子水平、雌孕激素受体表达情况,以及不同分期子宫内膜异位症患者的组织趋化因子水平、雌孕激素受体表达情况进行分析。结果与对照组相比,观察组患者趋化因子单核细胞趋化蛋白-1 (MCP-1)(205. 37±31. 24) ng/L和RANTES (626. 50±73. 39)μg/L水平均明显提高(P<0. 05)。与Ⅰ～Ⅱ期相比,Ⅲ～Ⅳ期患者趋化因子MCP-1 (228. 62±24. 95)ng/L和RANTES (679. 86±76. 91)μg/L水平均明显提高(P<0. 05)。与对照组相比,观察组患者雌激素受体(ER)阳性表达率36. 36%,孕激素受体(PR)阳性表达率31. 82%,均明显降低(P<0. 05)。与Ⅰ～Ⅱ期相比,Ⅲ～Ⅳ期患者ER阳性表达率25. 53%,PR阳性表达率19. 15%,均明显降低(P<0. 05)。结论组织趋化因子及雌孕激素受体表达对诊断和鉴别子宫内膜异位症及其病情危重程度均具有极其重要的临床参考价值。     

雌、孕激素类药物对不孕妇女子宫内膜雌激素受体含量的影响

对子宫内膜分泌不良的不孕妇女分别使用雌、孕激素类药物治疗31例(A组),单独使用孕激素治疗32例(B组),观察用药前后子宫内膜雌激素受体(ER)含量及组织学变化。结果表明,A组用药后ER含量明显增加(P<0.05),且组织学变化接近正常周期内膜或与其同步。而B组用药前后ER含量及组织学观察均无明显变化(P>0.05),部分病例ER含量有下降趋势。提示:对ER含量低下的子宫内膜发育不良患者,合理使用雌、孕激素类药物治疗,可提高靶细胞的受体含量、使内膜发育得到改善,是治疗不孕症的环节之一。     

孕康口服液对黄体功能不全致不孕不育患者雌孕激素及受体的影响

目的探究孕康口服液对黄体功能不全致不孕不育患者雌孕激素[雌二醇(E_2)及孕酮(P)]及受体[雌激素受体(ER)及孕激素受体(PR)]的影响。方法选取2015年2月-2016年10月北京市朝阳区双桥医院收治的96例黄体功能不全致不孕不育患者为研究对象,根据随机分配的原则分为对照组(48例)和观察组(48例)。对照组进行常规治疗,观察组在对照组的基础上加用孕康口服液治疗。比较两组患者治疗前后的血清E_2、P水平,子宫内膜腺上皮细胞及间质细胞ER及PR表达情况。结果治疗前,两组患者的血清E_2、P水平,子宫内膜腺上皮细胞及间质细胞ER及PR阳性率比较,差异均无统计学意义(均P0.05)。治疗后,观察组的血清E_2、P水平高于对照组,子宫内膜腺上皮细胞及间质细胞ER及PR阳性率低于对照组,差异均有统计学意义(均P0.05)。结论孕康口服液对黄体功能不全致不孕不育患者雌孕激素及受体的影响作用较大,在子宫内膜状态的改善方面具有积极的作用。     

定量分析雌孕激素对改善子宫内膜状态的作用

126例子宫内膜分泌不良的不孕妇女分别使用雌、孕激素类药物治疗(A组60例),单纯孕激素治疗(B组66例),用流式细胞仪定量观察用药前后子宫内膜雌激素受体(ER)、孕激素受体(PR)含量及组织学变化。结果表明,A组用药后ER、PR含量明显增加(P<0.05、P<0.01),且组织学变化接近正常月经周期内膜或与其同步。而B组用药前后ER、PR含量及组织学观察无明显变化(P>0.05,P>0.05),部分病例的ER、PR含量有下降趋势。提示对ER、PR含量低下的子宫内膜发育不良者,合理使用雌、孕激素类药物治疗,可提高靶细胞的受体含量、使内膜发育得到改善,是不孕症治疗的环节之一。     

双酚A暴露后子宫内膜胞饮突形态及HOXA-10基因表达的改变

目的建立双酚A(BPA)暴露的昆明雌鼠动物模型,研究暴露后子宫内膜胞饮突的形态学改变以及HOXA-10基因在mRNA水平和蛋白水平表达的改变,探讨BPA对子宫内膜容受性的影响及可能机制。方法将昆明雌鼠随机分成4组:高剂量暴露组、中剂量暴露组、低剂量暴露组和空白对照组。每组以花生油为溶剂,分别按250 mg/(kg·d),50 mg/(kg·d),10 mg/(kg·d),0 mg/(kg·d)进行BPA灌胃染毒,共28 d,第29天腹腔注射人绝经期促性腺激素(HMG)7.5 IU,48 h后腹腔注射h CG 10 IU,于当晚雌雄昆明小鼠1∶1合笼,次日可见阴道栓者为孕0 d,孕5 d后断椎处死,取出子宫,采用扫描电镜观察子宫内膜表面的胞饮突的形态学表现,应用Western Blot、免疫组化和荧光定量PCR测定HOXA-10的表达情况。结果扫描电镜结果提示,各剂量BPA干预组着床期胞饮突的数目均比对照组少,分布松散且不均,形态不一。HE染色显示,BPA干预组子宫宫腔均较对照组大,子宫内膜上皮细胞的高度较低,排列紧密,间质细胞连接紧密,腺体数量较少。荧光定量PCR、免疫组化和Western Blot结果提示,BPA干预组HOXA-10基因在mRNA及蛋白水平的表达量均较对照组降低(P<0.05)。结论通过对昆明雌鼠进行BPA的慢性暴露发现,BPA对小鼠胚胎着床期胞饮突的形成表现为抑制作用,同时抑制HOXA-10基因的表达。BPA可能通过改变子宫内膜容受性干扰胚胎着床。     

Effect of copper intrauterine device on the cyclooxygenase and inducible nitric oxide synthase expression in the luteal phase endometrium

Background

To evaluate the effect of copper intrauterine device (IUD) on the expression of cyclooxygenase (COX) and inducible nitric oxide synthase (iNOS) in the luteal phase endometrium.

Study Design

A prospective clinical study was conducted on 30 women who were willing to use a copper IUD contraception. Endometrial biopsies and blood samples were taken before and 3 months after the insertion of the IUD on Day 3 and Days 20–24 of the cycle. Main outcome measures were to evaluate the effect of copper IUD on uterine artery blood flow using pulsed color Doppler ultrasonography and the relationship of bleeding abnormalities and menstrual pain level with the uterine blood flow, COX-2 and iNOS expression.

Results

Only the left uterine artery pulsatility and resistance indices decreased statistically significantly (p=.005 and p=.039, respectively). Other Doppler parameters showed no change. Cyclooxygenase-2 expression of both endometrial luminal epithelium (p=.03) and gland epithelium (p=.03) increased significantly. Inducible NOS expression of the endometrial surface epithelium decreased significantly after IUD insertion (p=.01).

Conclusions

Although COX-2 expression increased 3 months after copper IUD insertion, iNOS expression of the luminal epithelium decreased. Local hypoxia caused by copper and vasoconstrictor prostanoids may play a role in IUD-related menstrual abnormalities.     

Effect of copper intrauterine device on the cyclooxygenase and inducible nitric oxide synthase expression in the luteal phase endometrium

BackgroundTo evaluate the effect of copper intrauterine device (IUD) on the expression of cyclooxygenase (COX) and inducible nitric oxide synthase (iNOS) in the luteal phase endometrium.Study DesignA prospective clinical study was conducted on 30 women who were willing to use a copper IUD contraception. Endometrial biopsies and blood samples were taken before and 3 months after the insertion of the IUD on Day 3 and Days 20–24 of the cycle. Main outcome measures were to evaluate the effect of copper IUD on uterine artery blood flow using pulsed color Doppler ultrasonography and the relationship of bleeding abnormalities and menstrual pain level with the uterine blood flow, COX-2 and iNOS expression.ResultsOnly the left uterine artery pulsatility and resistance indices decreased statistically significantly (p=.005 and p=.039, respectively). Other Doppler parameters showed no change. Cyclooxygenase-2 expression of both endometrial luminal epithelium (p=.03) and gland epithelium (p=.03) increased significantly. Inducible NOS expression of the endometrial surface epithelium decreased significantly after IUD insertion (p=.01).ConclusionsAlthough COX-2 expression increased 3 months after copper IUD insertion, iNOS expression of the luminal epithelium decreased. Local hypoxia caused by copper and vasoconstrictor prostanoids may play a role in IUD-related menstrual abnormalities.     

不孕妇女子宫内膜中肾上腺髓质素及其受体表达

目的:研究不孕妇女子宫内膜中肾上腺髓质素(ADM)及其相关受体CRLR表达的变化,探讨其与不明原因不孕的关系。方法:通过免疫组化、半定量RT-PCR及实时荧光定量RT-PCR等方法,研究原因不明不孕妇女(n=22名)与正常对照组妇女(n=20名)在种植窗口期(LH+6~LH+8)子宫内膜中ADM、CRLR蛋白表达和基因表达量的变化。结果:在正常对照组,ADM蛋白表达出现在内膜的各个细胞中,而不孕症组中间质细胞表达低于正常对照组(P<0.05);CRLR蛋白在内膜各细胞中的表达两组无差异(P>0.05);不孕妇女内膜中血管密度值为4.00±0.84,明显低于正常妇女的7.84±1.33(P<0.05);ADM mRNA不孕症组高于正常对照组3.99倍,CRLR mRNA两组无明显差异。结论:ADM及其受体CRLR通过影响内膜血管的生成而在内膜的生成、修复中发挥重要作用;在不明原因不孕组中,高表达的ADM mRNA尽管有助于种植窗口期孕卵的着床,但其对内膜血管的低调控作用导致内膜中血管密度降低可能是造成患者不孕的原因之一。     

Effect of systemic progesterone concentration on the expression of progesterone-responsive genes in the bovine endometrium during the early luteal phase

Increasing evidence indicates an association between the concentration of systemic progesterone during the early luteal phase of the oestrous cycle and embryo survival rate in cattle. We examined the relationship between the concentration of systemic progesterone on Days 4 to 8 post-ovulation and expression of progesterone receptor (PGR), oestrogen receptor +/- (ESR1) and retinol-binding protein (RBP) mRNA in the bovine endometrium. Heifers were blood sampled from the day of ovulation (Day 0) to Day 8 post-ovulation. On Day 4, animals were divided into low progesterone control (LC) and high progesterone control (HC) groups based on their plasma progesterone concentrations. Half of each group was supplemented with exogenous progesterone resulting in two further groups, low progesterone supplemented (LS) and high progesterone supplemented (HS). Endometrial tissues were recovered from all groups on Day 6 or Day 8 and gene expression was analysed following Northern blotting. Increasing progesterone concentrations were associated with decreased PGR and ESR1 expression. Duration-dependent effects of progesterone supplementation on ESR1 were evident and there was an effect of systemic progesterone concentrations between Day 0 and Day 4 on the expression of RBP at Days 6 and 8. Such progesterone-responsive changes in uterine gene expression are likely to affect embryo development.     

Progesterone receptors and proliferating cell nuclear antigen expression in equine luteal tissue

Steroid hormones act via specific receptors, and these play an important physiological role in the ovary. The objective of this study was to evaluate the cellular distribution of progesterone receptors and their staining intensity in different equine luteal structures during the breeding season, as well as their relationship to luteal cell composition, cell proliferation pattern and plasma progesterone (P4) concentration. There was an increase in proliferating cell nuclear antigen (PCNA) expression in large luteal cells from the corpus hemorrhagicum (CH) to mid-luteal phase, followed by a decrease toward the late luteal stage. In the CH, the number of large luteal cells was lower than in other structures. Only large luteal cells showed positive staining for P(4) receptors. An increase in staining intensity for P(4) receptors was observed between CH and mid-phase corpus luteum, and CH and late-phase corpus luteum. Synthesis of P(4) started at a very early stage of the luteal structure and was accompanied by an increase in P(4) receptors and PCNA expression, and proliferation of large luteal cells, until mid-luteal phase. These data suggest that large luteal cells might play an important role in the regulation or synthesis of P(4) in equine luteal structures.     

血清抗精子抗体与热休克蛋白在不孕症子宫内膜表达的相关性

目的:探讨血清抗精子抗体与热休克蛋白在不孕症子宫内膜表达的相关性。方法:对55例原发性不孕症子宫内膜行常规病理切片确定组织学类型,采用ELISA法检测血清抗精子抗体,采用免疫组化SP法标记HSP70在子宫内膜标本中的表达。结果:55例原发性不孕症子宫内膜标本中HSP70阳性表达36例,占65.5%,与子宫内膜组织学类型比较,差异有统计学意义(P<0.05);血清抗精子抗体阳性和阴性患者相比,有明显统计学差异(P<0.01)。结论:原发性不孕症患者子宫内膜HSPs的高表达可能是一种自身免疫应激反应。应用HSPs抑制剂抑制其合成,从而抑制HSPs基因的表达,进而为原发性不孕症的治疗开辟一种新的方法。     

育龄妇女对黄体期避孕的可接受性调查

目的:了解育龄妇女对米非司酮配伍米索前列醇用于黄体期避孕的可接受性。方法:向被调查者介绍该避孕方法后,问卷记录调查对象接受与否及原因。结果:共有1742人自愿参与本调查,曾使用过者占0.23%;接受该方法的调查对象年龄为28.4±2.47岁,不接受者的年龄为31.6±3.13岁,二者有统计学差异(P0.05);孕产次对接受与否无明显影响(P0.05);未婚者的接受性(48.2%)高于已婚者(35.4%);学生的可接受性最高(61.4%),农民最低(19.8%);文化程度高者接受性高于文化程度低者;在不接受该方法的人群中认为费事不方便最多(17.0%),还有一部分人担心影响今后的生育(13.8%)。结论:黄体期避孕在育龄妇女中了解程度低,存在一些担心,提示医疗服务机构应加强有关的宣传和咨询指导。