育龄妇女输卵管上皮周期变化的扫描电镜研究

为研究育龄妇女输卵管上皮表面结构，应用扫描电镜观察１９例妇科手术取出的处于不同月经周期的输卵管。结果：增生早期，输卵管上皮纤毛细胞数较多，无纤毛细胞粘膜面多向管腔膨隆；增生中晚期，纤毛细胞数最丰富，无纤毛细胞表面多呈球形、半球形突向管腔，突起表面微绒毛极少；分泌早期，纤毛细胞数减少，无纤毛细胞表面略膨隆；分泌中晚期，纤毛细胞数明显减少，无纤毛细胞表面较平坦，微绒毛短而稀疏。提示：育龄妇女输卵管上皮细胞表面存在周期性变化     

家兔输卵管结扎后其粘膜的扫描电镜观察

随机选用9只雌性家兔在双侧输卵管峡部行 Pomeroy 法结扎术,另取6只家兔做正常对照。分别于术后1、2、3个月定位取材,用扫描电镜观察。结果表明:大多数结扎后动物的输卵管粘膜异常,表现为近侧段输卵管管腔扩张,粘膜皱襞低平或消失,上皮纤毛脱落,病变随扎管后时间延长明显增加。此结果对绝育术后复通术的研究具有一定的参考意义。     

育龄妇女输卵管上皮周期变化的扫描电镜观察

为研究育龄妇女输卵管上皮表面结构，应用扫描电镜观察１９例妇科手术取出的处于不同月经周期的输卵管。结果：增生早期，输卵管上皮纤毛细胞数较多，无纤毛细胞粘膜面多向管腔膨隆；增生中晚期，纤毛细胞数最丰富，无纤毛细胞表面多呈球形、半球形突向管腔，突起表面微绒毛极少；分泌早期，纤毛细胞数减少，无纤毛细胞表面略膨隆；分泌中晚期，纤毛细胞数明显减少，无纤毛细胞表面较平坦，微绒毛短而稀疏。提示：育龄妇女输卵管上皮     

输卵管妊娠输卵管保留手术的术式分析

目的：探讨输卵管妊娠行输卵管成形术的时机及方法。方法：采用回顾分析及追踪随访的方法研究输卵管保留手术的术式分析以及术后3个月输卵管复通情况,随访2年的妊娠情况。结果：输卵管保留手术由于不同的术式,术后输卵管复通率及妊娠率各不一样,以输卵管妊娠纵行切开术后的复通率及再妊娠率最高（75％,47．44％）,以输卵管子宫植入术效果最差。结论：一般认为输卵管妊娠患者的输卵管内膜的纤毛,分泌细胞及输卵管肌层的机能已经不健全,因而对输卵管成形术的看法不同,但是如将妊娠部位的输卵管局部彻底切除后,剩下正常输卵管和伞部能残存4cm以上,手术后妊娠率则在40％以上,再次发生宫外孕的机率在20％以下。     

米非司酮对大鼠输卵管粘膜上皮生长的影响

目的 :利用米非司酮 (RU4 86 )阻断孕激素受体 ,观察孕激素作用被抑制后雌激素对输卵管的效应。方法 :实验动物选用成年SD雌鼠 ,体重 2 0 0～ 2 5 0g,随机分为RU4 86处理组和对照组 ,对照组动物根据阴道脱落细胞学检查又分为动情前期 (PE)组、动情期 (E)组、动情后期 (ME)组和动情间期 (DE)组。结果 :①光镜观察见RU4 86处理组输卵管粘膜上皮为假复层柱状 ,粘膜上皮细胞分化完全 ,由纤毛细胞和分泌细胞构成。经检测计量分析RU4 86处理组输卵管壶腹部粘膜上皮细胞高度较对照组各组明显增高 ,峡部粘膜上皮细胞高度未见明显变化。②增殖细胞核抗原 (PCNA)免疫组化实验结果发现大鼠输卵管壶腹部粘膜上皮细胞PCNA面积阳性率以RU4 86处理组最高 ,对照组中各组变化趋势为动情期 >动情前期 >动情间期 >动情后期 ,各组峡部粘膜上皮仅偶见PCNA阳性细胞。结论 :当孕激素效应被RU4 86拮抗后 ,雌激素对输卵管壶腹部粘膜上皮持续发挥了促细胞增长、增殖作用 ,继而可能导致输卵管的功能活动增强 ,并与正常生理状态具有一定的差异 ,但这一效应在峡部体现并不明显。提示雌、孕激素的相互拮抗作用对维持输卵管的正常功能活动 ,尤其对于壶腹部具有不容忽视的作用 ,在一定程度上反应输卵管壶腹部在生殖活动中的重要地位     

近端输卵管闭塞的病理形态及其超微结构探讨

目的探讨近端输卵管闭塞的病理形态和超微结构。方法采用回顾性方法对1985年1月-2004年12月间182例近端输卵管闭塞性不孕症患者进行分析，主要是闭塞的近端输卵管的病理形态改变，部分输卵管标本行透射电镜观察。结果导致输卵管近端闭塞的首位病因是输卵管非特异性慢性炎症，占67．02％，其次是输卯管管腔纤维闭塞和结节性输卯管炎，各占11．54％，再次为输卵管子宫内膜异位症，占6．60％，输卵管结核、输卵管异物结节以及未见明显病变者各占1．10％。透射电镜发现4例患者阻塞段输卵管切面为大量胶原纤维和少量的纤维细胞，排列较为紊乱，未见上皮和管腔；有1例仍可见输卵管上皮，但纤毛互相粘连填塞管腔，致使管腔变窄甚至闭锁，部分细胞纤毛出现退化或脱落，纤毛的横切面9＋2微管系统结构欠清晰，胞质内线粒体肿胀及内质网扩张，胞质内可见空泡。而邻近阻塞部位输卵管（通畅段）：电镜下上皮细胞主要由单层柱状分泌细胞和纤毛细胞构成，纤毛细胞顶端的纤毛排列比较规整，未见明显退化和脱落的现象。结论闭塞的近端输卵管呈多种病理类型改变，其主要病因是输卯管非特异性慢性炎症，其次为输卵管管腔纤维闭塞和结节性输卵管炎。感染及人工流产的增加可能是导致输卵管性不孕发病率增加的因素。     

胎儿输卵管上皮细胞分化观察

采用光镜和电镜技术观察了10周～38周胎儿输卵管上皮细胞特别是纤毛细胞的发育和分化。光镜下10周胎儿输卵管壶腹部管腔狭小,上皮为较原始的单层柱状上皮,12周粘膜上皮出现小的皱褶,16周～17周形成短的绒毛样突起,19周～32周渐形成较复杂的粘膜皱襞,至38周粘膜皱襞已接近成体。电镜下17周上皮中偶见单纤毛的细胞,胞质内细胞器较发达,糖原含量丰富,19周出现少量纤毛细胞,胞质细胞内器发达,可见溶酶体,此时纤毛较短,不具9×2+2微管结构,非纤毛细胞也有各种细胞器,但不含溶酶体。20周～30周纤毛细胞仍稀少,至32周以后纤毛细胞数量逐渐增多,其胞质中细胞器发达,糖原丰富,纤毛具典型的9×2+2微管结构,36周～38周可见形态分化较完好的纤毛细胞,非纤毛细胞顶端明显突向管腔,甚至落入管腔中,胞质内未见膜包的分泌颗粒。     

米非司酮对人输卵管上皮细胞超微结构的影响

目的探讨米非司酮对人输卵管上皮细胞超微结构的影响。方法取育龄妇女的输卵管壶腹部组织,米非司酮组(5例)于术前12 h给予米非司酮25 mg口服,对照组(5例)不服用米非司酮,用透射电镜观察其上皮细胞超微结构变化。结果与对照组相比,米非司酮组的输卵管上皮出现下列形态改变:①纤毛水肿,纤毛底座根少见或变短,微绒毛减少;②线粒体空泡化;③细胞质内自噬空泡、脂滴多见。结论小剂量单次服用米非司酮对人输卵管超微结构有一定影响。     

腹腔镜保守治疗输卵管妊娠病理观察

目的：对输卵管妊娠患者的腹腔镜输卵管线性切开保守性手术治疗进行病理观察。方法选择2011年1月至2013年12月该院收治已完成生育的输卵管妊娠患者,行线性切开、取胚、止血后,取出样本送病理检查,再行输卵管切除。结果未电凝处输卵管的组织结构正常,电凝处上皮破坏,无正常组织结构。电凝处边缘细胞线粒体肿胀,线粒体嵴变短,稀疏甚至消失,部分线粒体空泡化,染色质边集,部分纤毛脱落,基底膜完整。结论对有生育要求的输卵管妊娠患者行腹腔镜输卵管线性切开保守性手术可提高术后生育机会。     

正常豚鼠中耳粘膜扫描电镜观察

目的观察正常豚鼠中耳粘膜的形态学特征。方法应用扫描电镜对４只（８侧）豚鼠中耳腔粘膜进行多部位观察。 结果观察发现豚鼠中耳粘膜表面有地毯样粘液层。中耳粘膜的上皮细胞可分为４种类型,即纤毛细胞、无分泌颗粒无 纤毛细胞、有分泌颗粒无纤毛细胞和扁平细胞,在中耳腔的不同部位各种细胞的多少不均。结论中耳粘膜有真性呼吸 上皮的特性。     

家兔和人输卵管经复方硅橡胶栓堵后的形态学研究

通过光镜、透射电镜和扫描电镜观察了经复方硅橡胶栓堵后的家兔及人输卵管的组织学、粘膜上皮细胞的表面形态与超微结构的变化。说明复方硅橡胶作为输卵管可逆性绝育栓堵剂,绝育成功率高、效果稳定,对组织无腐蚀作用,经长期栓堵后仍有良好的复通性,应用前景广阔。     

胎儿喉室粘膜的扫描电镜观察

应用扫描电镜观察了６例不同胎龄胎儿的喉室粘膜上皮,发现胎儿的喉室粘膜上皮有４型细胞,即纤毛细胞、扁平细胞、无分泌颗粒无纤毛细胞和有分泌颗粒无纤毛细胞。声带粘膜上皮主要为扁平细胞,其它部位主要为纤毛细胞,但纤毛细胞的纤毛方向并不完全一致,间有无分泌颗粒无纤毛细胞和有分泌颗粒无纤毛细胞。提示在婴儿出生时,喉部的粘液纤毛系统已基本建立,声带的自洁作用远较其它部位差。     

子宫内膜异位症异位内膜的超微病理学改变及意义

目的 对子宫内膜异位症异位内膜腺上皮的超微结构进行研究,以求解析异位病灶本身所具有的特点及其在发病过程中所起的作用.方法 对子宫腺肌病和卵巢子宫内膜异位囊肿的异位内膜腺上皮进行透射电镜观察.结果 卵巢子宫内膜异位囊肿、子官腺肌病的异位内膜腺上皮具有与正常子宫内膜不同的超微病理学特征.结论 子宫内膜异位症异位内膜的超微结构改变使其能够突破机体的防御体系在"异域"生长.     

正常和子宫内膜异位症在位内膜的对比研究

目的对正常和子宫内膜异位症在位内膜的超微结构进行对比研究,探讨子宫内膜异位症的发病机制。方法对子宫内膜异位症在位内膜6例以及正常育龄妇女的子宫内膜3例进行超微结构对比研究。结果子宫内膜异位症在位内膜与正常子宫内膜的超微结构存在差异,具体表现在：前者分泌细胞的微绒毛和纤毛细胞的纤毛异常增多、变长;上皮细胞胞浆内线粒体明显增多;粗面内质网明显增多、扩张;脂滴及电子致密颗粒常见;基底膜弯曲。结论子宫内膜异位症的在位内膜与正常内膜有异,其随经血倒流入腹腔后,更易于在异位种植生长。     

生殖周期中大鼠输卵管粘膜上皮分泌细胞超微结构的变化

目的 :探索大鼠输卵管粘膜上皮分泌细胞在生殖周期中超微结构的动态变化。方法 :常规电镜技术处理、观察。结果 :在动情期达功能活跃状态 :细胞器发达 ,分泌颗粒成片 ,充满核上区 ;动情后期细胞器呈减少趋势 ,却未见如灵长类所显示显著的去分化 ;动情间期细胞器进一步减量 ,唯溶酶体和游离核糖体增多。结论 :大鼠输卵管粘膜上皮分泌细胞超微结构在生殖周期中存在周期性变化 ,但未见显著去分化过程。     

Ultrastructural Study of the Epithelium of Endometrial Glands in Women with Endometriosis.a Comparison with the Normal

Objective The ultrastructure of endometrium women suffering from endometriosis was compared with those from women of normal reproductive age.Materials & Methods Six specimens of eutopic endometrium were taken from women diagnosed with endometriosis. Three specimens were taken from women at normal reproductive-age. The specimens, all at early proliferative phase, were processed for ultrastructural study.Results Compared with the normal, the secretory cells of the epithelium of endometrium from women with endometriosis had more numerous and longer microvil li. In the cytoplasm, there were more secretory granules and mitochondria. The RER was more prominent and with dilated cisternae. Lipid droplets and electron dense particles were frequently seen. The cilia ciliated cells were increased and elongated remarkably. The basement membrane became markedly tortouas.Conclusion The endometrium from women with endometriosis showed a number of features which are abnormal. This might be the origin of endometriosis and a cause o f sterility.     

The Expression and Change of the β3 Integrin Subunit and Fibronectin in Normal Human Oviductal Tissue and Tubal Ectopic Pregnant Tissue

Objective To investigate the expression and change of the B3 integrin subunit and fibronectin in normal human oviductal t‘issue during various phases of the menstrual cycle and tubal ectopic pregnant tissue Methods Samples of normal ( n=29 ) and pregnant fallopian tube ( n=22 ) tissues were obtained from women who had normal cycle and history of normal pregnancy. Normal oviductal tissue samples were divided into 4 groups based on their menstrual cycle. Both expression and distribution of the B3 subunit and fibronectin were determined with the immunohistochemical method and the image analysis. Results The B3 subunit was expressed in the cytoplasm of ciliated cells. The expression level of the B3 subunit was higher after ovulation than that before ovulation in isthmus epithelium (P ＜0.001), and declined significantly after ovulation in ampullae epithelium (P ＜0.001). In umbrella epithelium within 4 days after ovulation, the expression level of the B3 subunit was observed at rather higher level among other phases (P ＜0.001). The ciliated and secretory cells of the epithelium except for where the pregnancy occurred in tubal pregnancy expressed the subunit, and no significant relationship was found between the normal tubal tissue of the secretory phase and tubal ectopic pregnant tissue (P＞0.05). Fibronectin was expressed in the basementmembrane of human oviductal epithelium and matrix. The expression level of fibronectin was higher in the hyperplastic phase than that in the secretory one (P＜0.001). And it was lower in normal tubal tissue of the secretory, phase than that in tubal ectopic pregnant tissue (P ＜0.001). Conclusion The B3 integrin subunit was expressed in the ciliated cells of human oviductal epithelium, and fibronectin was expressed in the basement membrane of human oviductal epithelium and matrix. Their expression and change in oviductal tissue is based on different phases of menstrual cycle. The B3 subunit could not related to the occurrence of tubal ectopic pregnancy. Fibronectin could be the potential molecular basis for the tubal ectopic pregnancy.     

大肠癌基质血管的微机图像定量分析

目的　研究大肠癌基质的血管定量参数 ,以探讨大肠癌与基质血管形成的关系。方法　用微机图像定量分析大肠癌块远近端瘤组织、癌块中心、癌块远近端肠粘膜的血管定量参数 ( D、 K、Sv、TA BA) ,显微镜下观察瘤细胞分化程度。结果　在 48例大肠癌中 ,所测血管定量参数显示 ,在癌远端 2cm处的肠粘膜与癌块远端癌组织、癌块远近端癌组织与癌中心组织、癌块近端癌组织与癌块近端 2、4cm处的肠粘膜之间 ,均有非常显著差异 (P <0 .0 1)。结论　大肠癌基质血管的形成与大肠癌的生长有密切关系 ,是其发生、发展、侵袭及转移的重要条件 ;大肠癌基质血管的形成与其临床病理过程相一致 ;血管定量参数与大肠癌的恶性程度判断有待进一步研究     

大鼠气管发生的形态学观察

本实验对胚胎第15天至出生后30天的大鼠气管上皮的发生过程进行了观察。证实胚胎第15天的气管上皮为假复层上皮,细胞表面有少量微绒毛;胚胎第17天,气管上皮出现典型的杯状细胞;胚胎第19天出现纤毛细胞;出生5天以后,上皮细胞增殖、聚集并内陷,形成气管腺。杯状细胞的粘液颗粒主要是中性粘多糖,气管腺的粘液颗粒为酸性粘多糖和中性粘多糖。实验结果表明:在胚胎期和生后早期,粘液纤毛运送系主要由纤毛细胞和杯状细胞等组成,出生5天以后,粘液纤毛运送系统主要由纤毛细胞和气管腺组成。     

A new modification of transanal Swenson pull-through procedure for Hirschsprung’s disease

Background The one-stage pull-through procedures for Hirschsprung＇s disease （HD） have become popular because it is well accepted by surgeons and mothers with no visible scar and a short hospital stay. It represents the latest development in the concept of a minimally invasive surgery for HD. We introduce a new method of transanal one-stage pull-through for Hirschsprung＇s disease, different from the transanal Scare procedure.
Methods One hundred and thirty-four patients aged 9 days to 5 years underwent a transanal one-stage pull-through procedure. The diagnosis was definite by barium enema or rectal biopsies preoperatively. The patients were anesthetized and placed in the lithotomy position. A urinary catheter was optional. Giving anorectal dilatations for half a minute, a pull-through of the rectum above the peritoneal reflection and into the intussusception was performed. Fine silk suturing was performed circumferentially at the level of that point which was used for traction for the distal end. Another circumferential suture was performed parallel 0.5 cm distance above the original one and used for traction for the proximal intestines. The full-thickness rectal wall was truncated between the above two circumferential sutures with cautery. The proximal intestines were pulled down and the mesenteric vessels were dissected with ligation until normal intestines were accessed; the presence of ganglion cells was determined by intraoperative rapid frozen section. The distal end was dissected anteriorly 2.5-3.5 cm above the dentate line. The posterior rectal wall was split longitudinally and dissected to a point 0.5-1.0 cm above the dentate line. The segment of the lesion was resected. The length of bowel resected ranged from 12 to 50 cm （median 16.5 cm）. An oblique anastomosis was made.
Results The mean operating time was 70 minutes. Postoperative rectal dilation was not required. The patient tolerated feeding on the first postoperative day. Eighty-eight patients were followed-up. All these patients ha