原位杂交检测HOXA-10基因在人子宫内膜的表达

目的 :探讨正常生育妇女月经周期不同时期子宫内膜腺上皮细胞、间质细胞中HOXA-1 0基因的表达。方法 :采用原位杂交的方法。结果 :HOXA-1 0基因在子宫内膜腺上皮细胞、间质细胞均有表达 ;中晚分泌期的表达高于增殖期及分泌早期 ,且间质细胞的表达高于腺上皮细胞。结论 :( 1 ) HOXA-1 0基因在分泌中期子宫内膜高表达提示其可能在人胚胎着床过程中起某种作用。 ( 2 ) HOXA-1 0基因可能在人子宫内膜蜕膜化过程中有重要作用。     

骨桥蛋白在人正常月经周期子宫内膜的表达

目的研究骨桥蛋白(osteopontin,OPN)在人正常月经周期子宫内膜的表达。方法采用免疫组织化学法对51例人正常月经周期子宫内膜OPN蛋白质进行定位和定量检测,Western blotting法测定增殖期及分泌期OPN蛋白水平,采用逆转录-聚合酶链反应(RT-PCR)方法检测18例人正常月经周期子宫内膜增殖期及分泌期OPN mRNA的表达。结果OPN蛋白质主要分布在正常子宫内膜腺上皮细胞,增殖早期、中期无表达,增殖晚期出现,分泌中期、晚期表达最强。月经期子宫内膜腺上皮细胞表达较强。OPN mRNA表达分泌期强于增殖期(P<0.05)。Western blotting检测结果显示正常子宫内膜组织中存在OPN蛋白,分泌期含量较高。结论OPN蛋白质及mRNA在正常子宫内膜中的表达呈现明显周期依赖性。分泌中、晚期表达增强提示其可能参与胚胎着床。     

Stathmin is highly expressed in eutopic endometrium of patient with endometriosis

Objective: To investigate the expression of stathmin in eutopic endometrium of women with or without endometriosis.Methods: The eutopic endometrium samples were collected from thirty-six women with endometriosis and nineteen age-matched women without endometriosis. The expression of stathmin protein was detected by immunohisto-chemistry and Western blot.Results: Stathmin was expressed in both endometrial glandular and stromal cells throughout the menstrual cycle. Stathmin expression had no significant difference between proliferative and secretory phase. Stathmin was overexpressed in eutopic endometrium of women with endometriosis compared with those without endometriosis.Conclusion: The overexpressed stathmin in endometrium of patient with endometriosis may play a certain role in the pathogenesis of endometriosis.     

Expression of osteopontin in human endometrium throughout menstrual cycle

<正> Objective:To analyze mRNA and protein expression of osteopontin(OPN)in human endome-trium throughout menstrual cycle.Methods:Immunohistochemieal method was used to determine the level and the location ofOPN in normal cycling endometrium of 50 women.Western Blot analysis was also used to detectthe existence of OPN at proliferative and secretory phases in six samples.The levels of OPNmRNA in 18 samples were measured by RT-PCR.Results:The OPN mainly expressed in human endometrial glandular epithelium but not instromal cells.The expression was highest at mid and late secretory phases and menstruous phaseas well.No expression was found in early and mid proliferative endometria.Two subtypes ofOPN proteins(40 kDa-75 kDa)were detected by Western blot analysis in homogenized endome-tria at secretory phase.The level of OPN mRNA in secretory phase endometrium was significantlyhigher than that in proliferative phase.Conclusions:OPN was only found in endometrial glandular epithelial cells,and the OPN andits mRNA showed a pronounced cycle-dependent expression in human endometrium,higher ex-pression at mid and late secretory phases and menstruous phase.It's probably involved in embry-onic implantation and endometrial shedding.     

对人子宫内膜月经周期中增殖细胞核抗原标记细胞的探讨

本实验使用因子宫肌瘤摘出的子宫标本４０份。根据主诉与子宫内膜标本ＨＥ染色，将标本分成８个期。免疫组织化学法进行子宫内膜月经周期增殖细胞核抗原（ＰＣＮＡ）染色反应。结果发现，ＰＣＮＡ标记细胞在增殖初期腺上皮（４０％）和增殖中期间质中部（４８％）标记率最高，而表面上皮细胞中很少；排卵期可见腺上皮的ＰＣＮＡ标记细胞再次增加；分泌期只有间质中可见ＰＣＮＡ标记细胞。本结果对人月经周期正常子宫内膜细胞增殖变化情况提供了新资料。     

Fluorescence hysteroscopy using 5-aminolevulinic: a descriptive study

BACKGROUND AND OBJECTIVES: To assess the feasibility of fluorescence hysteroscopy following topical ALA application and to describe the optical appearance of normal and neoplastic endometrium. STUDY DESIGN/MATERIALS AND METHODS: Fifty-four patients scheduled for routine hysteroscopy and D&C were assigned to the study group using topically applied ALA. Two milliliters of a 2% 5-ALA-solution at pH = 4.0 (ASAT AG/Zug, Switzerland) was administrated into the uterine cavity 4 hours before fluorescence hysteroscopy, using a STORZ-D-Light (Tuttlingen, Germany) system. Hysteroscopic findings were compared to the histological diagnosis of hematoxylin & eosin (H&E) stained sections. In the study group, 60 histological specimens were taken (47 materials of curettage and 13 targeted biopsies). The percentage of fluorescence positive patients was calculated. RESULTS: The rate of fluorescent endometrial samples was low in atrophic endometrium 1/16 (6.2%). Endometrial carcinoma were diagnosed in two patients. Both cases exhibited selective and intense PpIX-mediated red fluorescence. Fluorescence hysteroscopy could not differentiate between hyperplastic areas with or without atypia. Minimal uterine cramps or discomfort following ALA instillation were complained by 30 (56%) patients, no pain was indicated by 24 patients (44%). CONCLUSIONS: Fluorescence hysteroscopy following intrauterine application of ALA is feasible. Cancerous, hyperplastic, and secretory endometrial tissue showed high red fluorescence.     

类肝素结合性表皮生长因子在人子宫内膜植入窗期的表达和意义

探讨类肝素结合性表皮生长因子 (HB-EGF)在人正常子宫内膜中的表达特点 ,评估其在子宫内膜的生长、分化及在植入窗期介导胚泡着床中的作用。采用免疫组织化学方法检测 5 6例正常子宫内膜 (1 6例增殖期 ,1 3例分泌早期 ,1 5例分泌晚期 ,1 2例植入窗期 )中 HB-EGF的表达及定位。结果 :HB-EGF在人各期子宫内膜均有表达 ,在植入窗期或分泌中期子宫内膜上皮细胞和间质细胞表达最强 ,并定位于腺上皮和腔上皮细胞表面 ,呈顶浆分泌状。结论 :HB-EGF存在于人各期子宫内膜 ,在植入窗期明显高表达可能参与介导胚泡着床 ,并与间质细胞的生长、分化有关 ,利于子宫内膜蜕膜化 ,为胚泡着床做准备。     

激素替代治疗后子宫内膜组织形态学与增殖细胞核抗原指数变化

目的 :探讨激素替代治疗后子宫内膜组织形态变化与增殖指标增殖细胞核抗原 ( PCNA)指数之间的关系。方法 :选择正常增殖期、分泌期、绝经后的子宫内膜及接受激素替代治疗 ( HRT)后的子宫内膜 ,根据病理诊断分为增殖期与分泌期 ,分别检测其中的PCNA水平。结果 :正常月经周期子宫内膜组织形态与 PCNA指数二者皆能反映子宫内膜的增殖与抑制状态。HRT后子宫内膜的形态 ,增殖期与分泌期与 PCNA指数所反映的内膜增殖与抑制状态有差异 ,PCNA水平与用药情况相符合。结论 :HRT后子宫内膜的增殖与抑制状态需要综合判断。     

月经周期子宫内膜凋亡与Bc1-2、Fas及Fas-L基因表达产物的相关研究

为探讨子宫内膜凋亡与某些相关基因表达产物的关系,应用免疫组化方法对４６份正常子宫内膜标本Ｂｃ１－２、Ｆａｓ及Ｆａｓ－Ｌ基因表达产物进行检测,并应用ＴＵＮＥＬ法对其中１３份标本同时进行凋亡检测。结果表明：分泌晚期及月经期凋亡细胞较多,血内雌二醇、孕酮水平低下;Ｂｃ１－２蛋白在增殖晚期含量高、分泌期低落、月经期消失;Ｆａｓ则在分泌期及月经期略高于增殖期,而Ｆａｓ－Ｌ表达产物低下。结论：子宫内膜的凋亡呈现周期性改变,与Ｂｃ１－２、Ｆａｓ表达相关,并受雌、孕激素显著调节,提示凋亡与月经期内膜脱落相关。     

正常与异常子宫内膜中Bc1-2、Bax mRNA表达

为了解正常和异常子宫内膜中 Bc1 -2和 Bax m RNA的表达及与凋亡的关系。应用原位杂交方法检测了 2 7例正常子宫内膜 ,1 2例子宫内膜增殖症和 1 0例癌变子宫内膜 Bc1 -2和 Bax m RNA的表达情况。结果 :正常子宫内膜组织腺细胞 Bc1 -2与 Bax m R-NA表达的比例与子宫内膜的周期性变化密切相关 ,Bc1 -2 m RNA表达在增殖期增强 ,分泌期减弱 ,Bax m RNA表达则相反。增殖症和癌变子宫内膜组织中 ,Bc1 -2和 Bax m RNA表达呈正相关 (rs=0 .886 ,P<0 .0 5) ,随着子宫内膜由良性增生到恶性增生 ,Bc1 -2 m R-NA表达逐渐减弱至丧失表达 ;Bax m RNA在增殖症子宫内膜中 ,随着增生的异型化 ,表达逐渐增强 ,而在癌变子宫内膜中 ,随着病理分级的降低 ,表达逐渐降低。结论 :Bc1 -2和Bax基因对于维持正常子宫内膜周期性变化的平衡起着重要作用 ,在增殖症和癌变子宫内膜中表达的异常变化可能与子宫内膜癌生物学行为和预后相关。     

Study on association between apoptosis of endometrial cells and Bcl-2, Fas, Fas-L expressions durig menstrual cycles

IntroductionMorphologicalapoptosisinthehumanendometriumwasfirstreportedbyHopwoodandLevison[lj,butthemechanismofapoptosiswasnotstudieduntilrecentyears.ItisknownthatBcl--2inhibitsapoptosis,Fasinducesapoptosis,Fas--ListhenaturalligandofFas.SotheexpressionsofBcl--2,FasandFas--Lareallcloselyrelatedtocellapoptosis.ThecurrentstudyexaminestherelationshipsbetweenapoptosisandtheexpressionsofBcl--2,FasandFas--Linhumanendometiumduringmenstrualcycles.MaterialandMethodsTissueSamplesFourly--sixnormal…     

转化生长因子β1在不明原因不育症着床窗期子宫内膜的表达

目的　探讨转化生长因子 β1(TGFβ1)在月经周期子宫内膜组织的表达规律 ,了解其对子宫内膜着床窗期的作用以及与不明原因不育症的关系。　方法　应用免疫组织化学法检测TGFβ1在增殖期 (2 5例 )、分泌期 (2 9例 )子宫内膜、不明原因不育症着床窗期内膜 (12例 )的表达。　结果　TGFβ1在早、中增殖期腺体及间质细胞大多无表达或弱阳性 ,晚增殖期表达明显增加 ,与早、中增殖期相比 ,在腺上皮细胞胞浆染色显著增强 (P <0 .0 1)。TGFβ1在中分泌期内膜腺体和间质细胞胞浆表达丰富 ,与早分泌期比较均有明显增强 (P <0 .0 1)。在不明原因不育症着床窗期内膜间质细胞TGFβ1的表达强度较对照组显著下降 (P <0 .0 5 )。　结论　TGFβ1调节子宫内膜生长、分化 ,可能参与胚胎的着床过程。TGFβ1在不明原因不育症着床窗期表达下降 ,可能是导致不明原因不育症的重要原因之一。     

正常月经周期中内皮素变化规律的研究

目的 :探讨健康育龄妇女正常月经周期中血浆及子宫内膜内皮素 ( ET)的变化 ,ET和卵巢甾体激素的相关性。方法 :对 3 8名正常月经周期妇女分别于增殖早、中期 ,分泌中、晚期 ,取 4次静脉血 ,应用放射免疫方法测定血浆 ET、雌激素 ( E2 )、孕激素 ( P)含量 ,其中 2 7名妇女选择某一期 ,采血同时取内膜测定子宫内膜 ET含量。结果 :正常月经周期各阶段血浆 ET水平无明显差异。子宫内膜组织 ET,分泌中、晚期 ( 3 .90± 1 .3 0 pg/mg)显著高于增殖早、中期 ( 2 .76± 1 .2 5 pg/mg) ( P<0 .0 5 )。无论是血浆 ET还是子宫内膜组织 ET均与雌、孕激素之间无明显相关性。结论 :子宫内膜中的 ET可能通过自分泌和 (或 )旁分泌机制参与子宫出血的调节 ,并与月经的始动有关。     

宫腔镜在绝经期子宫内膜增厚诊疗中的价值

目的探讨官腔镜在绝经期子宫内膜增厚（内膜〉5mm）的诊疗意义。方法2004年10月-2008年10月我院389例绝经期子宫内膜增厚（超声发现内膜增厚〉5mm）,先行诊断性刮宫,然后行宫腔镜内膜切除术,比较2种方法诊断结果及对子宫内膜癌的阳性预测值。结果29例诊刮时无组织刮出或仅有极少量组织刮出难以送病检,无法明确病因,行TCRE病理诊断证实子宫黏膜下肌瘤5例,子宫内膜息肉14例,增生期子宫内膜9例,子宫内膜癌1例。10例因官腔镜扩张宫口未达10mm,或子宫穿孔未继续行官腔镜检,TCRE取材失败,仅行诊刮,病理诊断：子宫内膜癌1例,子宫内膜炎6例,子宫内膜息肉3例。TCRE和分段诊刮对于子宫内膜癌的阳性预测值分别为100．0％（102／102）和50．0％（51／102）,差异有显著性（P=0．000）。结论绝经期子宫内膜增厚,常规行宫腔镜检查,可提高诊断的准确率,早期发现子宫内膜癌,良性病变能同时获得治疗。     

Bcl-X expression in normal endometrium, endometrial hyperplasia and adenocarcinoma

IntroductionThat apoptosis occurred in normal endometrium, endometrial hyperplasia and adenocarcinoma has been demonstrated by severalstudiesll 4]. The susceptibility of an individualcell to apoptosis is determined by the balanceof numerous intracellular proapoptotic and antiapoptotic gene expression. Recently, itwas shown that apoptosis in human endometrium was related to the expression ofBcl--2 and Ba-c[5'6]. Bcl--X, one of the membersof the Bcl--2 family, through alternate splicing, produ…     

子宫内膜整合素αvβ3表达与体外受精-胚胎移植反复种植失败的相关性研究

目的研究整合素αvβ3在人各时期子宫内膜及蜕膜组织的表达,并探讨其与体外受精-胚胎移植（IVF-ET）反复种植失败的相关性。方法以40例IVF-ET治疗反复种植失败的患者为研究对象,以40例因男性因素行卵胞浆内单精子注射（ICSI）治疗的患者及5例正常孕早期患者作为对照,获取患者各个时期的子宫内膜及蜕膜组织,采用免疫组织化学法检测整合素αvβ3蛋白的定位和表达,并对所获得的结果应用Image-ProPlus6．0图像分析软件测定阳性反应强度。结果整合素αvβ3蛋白定位于子宫内膜腺上皮细胞和腔上皮细胞的细胞浆;增殖早、中、晚期及分泌早期内膜上均无表达,分泌中期、晚期内膜明显表达,蜕膜中表达最强（P〈0．05）。反复种植失败患者子宫内膜整合素αvβ3的表达同样存在周期性变化,但其在分泌中、晚期的表达要明显弱于对照组,差异有统计学意义（P〈0．05）。结论整合素αvβ3在正常子宫内膜组织中的表达呈现明显周期依赖性,与胚胎种植密切相关;而其在IVF—ET反复种植失败患者种植窗期子宫内膜组织中的表达明显减弱,可能是导致胚胎种植失败的原因之一。     

释放左旋18-甲基炔诺酮(20μg)宫内节育器的研究回顾

目的总结我所对释放20μg左旋18甲基炔诺酮宫内节育器(LNGIUD)的研究,以阐明其作用机理、长效避孕效用和安全性。方法本文是我所发表的22篇临床报告和研究论文的综合分析。结果观察100例避孕效果,使用8年仅1例妊娠,续用率为52%,因医学原因取器为32.2%。观察10例随访1年有排卵周期者占44.8%,置器6年后,14例中有排卵周期者占78.5%;血清LNG水平有排卵者低,无排卵者高,提示闭经是高浓度LNG对子宫内膜的局部作用。形态学观察显示置器后子宫内膜增生受到抑制,内膜细胞核DNA含量明显下降,内膜细胞雌激素受体(ER)、孕激素受体(PR)表达受到抑制,内膜血管细胞因子VIII(FVIII)活性明显减低。提示月经的改变是LNGIUD对子宫内膜的局部作用。观察34例特发性月经过多的治疗达3年,月经血量(MBL)显著下降,血红蛋白(Hb)和铁蛋白明显增加。结论释放20μg的LNGIUD是一个安全、高效、长效、可逆的避孕方法。主要优点是降低MBL,可接受性高,适合于我国实际应用。尤其对月经过多和贫血的妇女,更应优先选择。     

子宫内膜息肉中雌、孕激素受体的表达

目的检测子宫内膜息肉雌激素受体(ER)、孕激素受体(PR)的表达,探索子宫内膜息肉形成的原因及机制。方法子宫内膜息肉48例为观察组,正常子宫内膜36例为对照组,采用免疫组化SP法,行半定量分析,检测ER、PR的表达。结果增殖期的息肉组织中PR表达的评分结果为(2.89±2.16),低于增殖内膜的评分(4.04±1.73),差异有统计学意义(P<0.05);分泌期的内膜息肉中ER表达的评分结果为(3.80±1.64),高于分泌期内膜中的评分(2.64±1.45),差异有统计学意义(P<0.05)。结论增殖期的子宫内膜息肉中PR的表达降低及分泌期的息肉中ER表达增高可能参与了子宫内膜息肉的形成及发展。     

原位杂交检测孕酮受体mRNA在周期子宫内膜的表达

应用地高辛标记的探针进行原位杂交，检测周期内膜各组分的孕酮受体（ＰＲ）ｍＲＮＡ的表达。内膜取自子宫肌瘤患者，子宫全切术后即取内膜及部分肌层，储于液氮。据月经史及形态表现将内膜分为三期：增殖、分泌早期及中晚分泌期。结果显示，ＰＲｍＲＮＡ在子宫内膜的表达有明显的组织／细胞差异。基质细胞普遍表达ＰＲｍＲＮＡ，增殖期与分泌期比较无明显差异。中晚分泌期内膜腺体细胞ＰＲｍＲＮＡ的表达极低甚至不表达，且无明显的表浅及深层的表达差异。提示子宫内膜孕酮受体至少在腺体上可能存在转录水平的调节。     

Expression Level of Hoxa-10 is decreased at time of implantation in glandular epithelium of human endometrium

Aim: To explore the connection between Hoxa-10 and humanimplantation by observing the expression pattern of Hoxa-10 in hu-man endometrium during normal menstrual cycle. Methods:Human Hoxa-10 Riboprobe was prepared and the expression ofhomeobox gene Hoxa-10 in the human endometrium during men-strual cycle was determined through in situ hybridization. Re-sults: Hoxa-10 expressed in both glandular cells and stromalcells at proliferative phase and early secretory phase. But the ex-pression of Hoxa-10 was markedly decreased or disappeared inglandular epithelium at the mid secretory phase, which correspondsto the time of implantation, and at late secretory phase. Conclu-sion; The results suggest that Hoxa-10 may play an essential rolein establishing necessary conditions for implantation. (Reprod Con-tracep 2001; 21: 149-52)