老年子宫颈癌患者生存情况及其影响因素分析

目的:探讨影响老年子宫颈癌患者术后生存的影响因素.方法:对1980年1月～1998年12月诊治的老年子宫颈癌243例临床资料和随访结果进行回顾性分析.采用Kaplan-Meier法计算累积生存率,用Log-Rank法比较各因素不同水平生存分布的差异,进一步应用COX回归模型进行预后因素分析.结果:全组子宫颈癌术后5、10、15年累积生存率分别为87％、81％、75％,Log-Rank分析结果显示不同临床分期、不同组织分化程度、有无淋巴结转移、不同治疗方法患者生存差异存在明显差异(x2=23.172,P＜0.05;x2=32.766,P＜0.05;x2 =25.086,P＜0.05;x2 =28.906,P＜0.05).年龄、不同生长方式、肿瘤直径、有无辅助治疗水平间生存差异无统计学意义(P＞0.05),COX模型多因素分析表明:临床分期、组织分化程度、淋巴结转移是影响预后的独立因素(P＜0.01).结论:临床分期、淋巴结转移、组织分化是影响老年子宫颈癌预后的独立危险因素,及早发现和合理降低临床分期是治疗老年子宫颈癌以及提高预后的关键手段.     

子宫内膜微创技术对体外受精和胚胎移植妊娠结局影响的研究

目的探讨子宫内膜微创术对不孕症妇女体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法选择2010年1月-2012年6月在新疆医科大学第一附属医院生殖助孕中心74例接受IVF-ET/卵胞浆内单精子注射(ICSI)的不孕症患者,以采用子宫内膜微创术的41例患者作为治疗组,在促排周期月经来潮24h内进行子宫内膜微创术;以未进行子宫内膜微创术的33例为对照组,比较两组的胚胎种植率及临床妊娠率。结果治疗组与对照组胚胎种值率分别26.51%和11.43%,差异有统计学意义(P<0.05);治疗组与对照组临床妊娠率分别为43.90%和21.21%,差异有统计学意义(P<0.05)。结论不孕症妇女进行子宫内膜微创术后能够显著提高IVF-ET/ICSI周期的胚胎种植率及临床妊娠率,改善妊娠结局。     

米非司酮对不同月经周期异位和在位子宫内膜雌激素受体α和孕激素受体表达的影响

目的 探讨米非司酮对雌激素受体α(ERα)和孕激素受体(PR)在不同月经周期的子宫腺肌症中表达的影响.方法 47例行全子宫切除术的子宫腺肌症患者分为米非司酮组(n=24)和未用药组(n=23);无腺肌症的正常子宫内膜作为对照组(n=15).运用免疫组化的方法测定异位和在位子宫内膜及正常子宫内膜在不同月经周期的腺上皮及间质细胞中ERα和PR水平.结果 未用药组ERα和PR在异位子宫内膜腺上皮及间质细胞中的表达均低于在位内膜及对照组正常内膜(P<0.05).对照组及未用药组ERα和PR在在位内膜腺上皮细胞中的表达,增生期高于分泌期(P<0.05),而在未用药组异位内膜,差异无统计学意义(P>0.05).ERα和PR在异位和在位子宫内膜中的表达,米非司酮组低于未用药组(P<0.05).结论 ERα和PR在异位子宫内膜中的表达与在位子宫内膜不同;异位内膜丧失了正常内膜的周期性变化规律;米非司酮通过下调其性激素受体(ERα和PR)含量治疗子宫腺肌症.     

Coexistence of benign phyllodes tumor and invasive ductal carcinoma in distinct breasts: case report

This report describes a rare case of coexistence of benign phyllodes tumor, which measured 9 cm in the right breast, and invasive ductal carcinoma of 6 cm in the left breast, synchronous and independent, in a 66-year-old patient. The patient underwent a bilateral mastectomy due to the size of both lesions. Such situations are rare and usually refer to the occurrence of ductal or lobular carcinoma in situ when associated with malignant phyllodes tumors, and more often in ipsilateral breast or intra-lesional.     

Global vascular expression of murine CD34, a sialomucin-like endothelial ligand for L-selectin

Extravasation of leukocytes into organized lymphoid tissues and into sites of inflammation is critical to immune surveillance. Leukocyte migration to peripheral lymph nodes (PLN), mesenteric lymph nodes (MLN) and Peyer's patches (PP) depends on L-selectin, which recognizes carbohydrate-bearing, sialomucin-like endothelial cell surface glycoproteins. Two of these ligands have been identified at the molecular level. One is the potentially soluble mucin, GlyCAM 1, which is almost exclusively produced by high endothelial venules (HEV) of PLN and MLN. The second HEV ligand for L-selectin is the membrane-bound sialomucin CD34. Historically, this molecule has been successfully used to purify human pluripotent bone marrow stem cells, and limited data suggest that human CD34 is present on the vascular endothelium of several organs. Here we describe a comprehensive analysis of the vascular expression of CD34 in murine tissues using a highly specific antimurine CD34 polyclonal antibody. CD34 was detected on vessels in all organs examined and was expressed during pancreatic and skin inflammatory episodes. A subset of HEV-like vessels in the inflamed pancreas of nonobese diabetic (NOD) mice are positive for both CD34 and GlyCAM 1, and bind to an L-selectin/immunoglobulin G (IgG) chimeric probe. Finally, we found that CD34 is present on vessels of deafferentiated PLN, despite the fact that these vessels are no longer able to interact with L-selectin or support lymphocyte binding in vitro or trafficking in vivo. Our data suggest that the regulation of posttranslational carbohydrate modifications of CD34 is critical in determining its capability to act as an L-selectin ligand. Based on its ubiquitous expression, we propose that an appropriately glycosylated form of vascular CD34 may act as a ligand for L-selectin-mediated leukocyte trafficking to both lymphoid and nonlymphoid sites.     

Asthma caused by potassium aluminium tetrafluoride: a case series

The objective of this study is to describe a case-series of potassium aluminium tetrafluoride (KAlF₄)-induced occupational asthma (OA) and/or occupational rhinitis (OR). The study involves five patients from a heat-exchanger production line who were examined (including specific inhalation challenge tests) for suspected OA and/or OR caused by a flux containing almost 100% KAlF₄ − with fluorides’ workplace air concentrations ranging between 1.7 and 2.8 mg/m³. No subject had a previous history of asthma. All five patients had a positive specific challenge test (three patients were diagnosed with OA alone, one with OR and one with both OR and OA). At the follow-up visit, after three years on average, all patients needed permanent corticosteroid therapy (four topical, one oral). After elimination from the exposure, only one of the observed subjects gave an indication of an improvement, two subjects stabilized and two worsened. Our case series focuses on the correlation between patients’ exposure to fluorides in air-conditioner production and the subsequent occurrence of OR/OA. Currently, it is uncertain whether these OR/OA were caused by hypersensitivity or irritation.     

腹腔镜手术对不孕症患者的诊断及治疗价值研究

目的探讨腹腔镜手术对不孕症患者的诊断及治疗价值。方法回顾性分析新疆医科大学第一附属医院2010年9月-2014年5月收治的319例不孕症患者的临床资料,对所有患者行腹腔镜下诊断及相应的手术治疗(包括盆腔粘连分解、输卵管造口术、输卵管灼断术等)。结果 319例患者腹腔镜术中检查与术前子宫输卵管碘油造影结果的符合率为72.1%(230/319),其中有43例术中发现子宫肌瘤,56例术中发现输卵管系膜囊肿,8例患者术中发现子宫内膜异位症,有2例患者诊断为盆腔结核,1例术中发现结肠肌瘤(术前考虑卵巢囊肿),其余为不同程度的盆腔慢性炎症。轻度粘连69例,妊娠21例,宫外孕2例,妊娠率33.33%。中重度粘连250例,其中行灼断术34例,灼断术患者后行体外受精及胚胎移植(IVF-ET),妊娠13例,妊娠率38.23%(13/34)。其余216例,失访3例,妊娠31例,宫外孕3例、妊娠率15.9%。结论腹腔镜对诊断输卵管性不孕及盆腔疾病有重要价值,子宫输卵管造影仅能初级筛查,诊断价值有限。在治疗输卵管粘连梗阻中,腹腔镜的治疗价值有待进一步探讨,临床预后与盆腔炎症的程度有关,应个体化选择手术方案。