200 IU hCG替代hMG在晚卵泡期应用于控制性卵巢刺激的疗效观察

目的:探讨200 IU hCG在控制性卵巢刺激(COS)过程的晚卵泡期替代hMG对COS的疗效。方法:回顾性分析行体外受精/单精子卵胞质内注射-冻融胚胎移植(IVF/ICSI-FET)患者资料共154例,进行154个COS周期,根据晚卵泡期是否应用200 IU hCG分为:A组,COS完全应用hMG(65个周期);B组,COS的早卵泡期应用hMG,晚卵泡期则应用hCG(200 IU/d)替代hMG(89个周期)。后续166个周期进行FET,其中,A组70个周期,B组96个周期。统计分析COS周期的用药情况、IVF/ICSI-FET结局。结果:B组的hMG用药剂量和用药时间分别显著少于A组(1 361.0±494.6 IU vs 1 782.7±475.2 IU,P0.05;7.3±2.3 d vs 9.5±2.0 d,P0.05);B组的成熟卵母细胞数显著多于A组(15.2±6.6 vs 11.6±5.7,P0.05);冻融胚胎移植中A、B组的临床妊娠率(64.29%vs 64.58%,P0.05)及活产率(80.00%vs 79.03%,P0.05)比较无统计学差异。结论:200 IU hCG能够在COS的晚卵泡期替代hMG,能安全、有效地维持卵泡生长发育,并且减少Gn的用量,避免卵巢过度刺激综合征(OHSS)发生。     

基于基因免疫制备抗人绒毛膜促性腺激素β亚基单克隆抗体及其特性研究

用真核表达人绒毛膜促性腺激素β亚基((human chorionic gonadotrophinβ,hCGβ)的重组质TR421-hCGβ免疫BALB/c小鼠,采用B淋巴细胞杂交瘤技术进行细胞融合,ELISA法筛选阳性细胞株,经过多次的克隆化培养,最终获得10株持续、稳定分泌抗hCGβ单克隆抗体的杂交瘤细胞株。随机抽取6H1杂交瘤细胞进行抗体的制备、纯化及免疫学特性的分析。间接ELISA法证明6H1单抗属于IgG2a亚类。Western blot证明6H1单克隆抗体可以特异性结合hCGβ,间接免疫荧光和流式细胞仪等结果表明,6H1单克隆抗体能够不同程度的结合不同来源的肿瘤细胞膜上表达的hCGβ分子,为进一步研究其生物学功能奠定了物质基础。     

Endometrioid carcinoma of the endometrium with choriocarcinomatous differentiation: a case report and review of the literature

OBJECTIVE: An endometrioid adenocarcinoma (EAC) with true trophoblastic differentiation is a rare event with a highly aggressive clinical course. CASE: We report an endometrioid adenocarcinoma of the endometrium in which there was a morphologically conventional-appearing EAC component admixed with multinucleated giant cells and large pleomorphic tumor cells that resembled a choriocarcinoma without an elevated serum level of human chorionic gonadotropin (hCG) in a 42-year-old unmarried woman with a history of abnormal uterine bleeding. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection were performed. Histopathologic study of the specimen showed endometrioid adenocarcinoma extended to the deep myometrium with a focus of hemorrhagic and necrotic tumor composed of multinucleated giant cells, large pleomorphic tumor cells, suggesting choriocarcinomatous differentiation (CD). Immunohistochemical studies demonstrated intense reactivity of tumor cells for human chorionic gonadotropin (hCG) confirming the diagnosis. A complete clinical workup ruled out metastatic spread to the brain, lungs, skeleton, or abdomen. The patient was alive with no evidence of disease 6 months later. CONCLUSION: Although endometrioid adenocarcinoma with choriocarcinomatous differentiation is known to behave in a more aggressive course, this disease may have a good prognosis with a clinically indolent course when it is small, and without elevated serum hCG levels.     

The only effects of recombinant follicle-stimulating hormone for ovulation induction in the pre-implantation period of rats

Objective The aim of this study was to evaluate the changes in follicular development, serum hormonal levels, and endometrium in the pre-implantation period of rats by using recombinant FSH (rFSH) without human chorionic gonadotropin (hCG). Methods Thirty female rats were studied in six groups of five specimens. Two groups determined as controls (groups 1 and 2). Two groups received constant doses of rFSH (groups 3 and 4) and other two decreasing doses (groups 5 and 6). One of the paired groups was mated. Uterus, ovaries, and blood samples were taken from non-mated groups (groups 1, 3, and 5) at the proestrus period and from mated groups (groups 2, 4, and 6) in the pre-implantation period. Results In non-mated groups antral follicles and corpus luteum periodicum and in mated groups antral follicles, corpus luteum periodicum, and corpus luteum graviditatis were increased in rFSH groups, especially in decreasing dose groups. Estradiol (E₂) levels were increased and progesterone (P)/E₂ ratio was significantly decreased in decreasing dose groups. Endometrium surface epithelium was columnar, irregular, and folded in rFSH groups. Endometrium glandular epithelium was cuboidal in all groups. In decreasing dose groups endometrial stroma was smooth and fibroblastic. Mitotic indices of endometrium surface, glandular epithelium, and stroma were significantly decreased in rFSH groups. Primary follicles and P levels showed no change. Conclusion It seems likely that decreasing doses of rFSH might be used in order to improve follicular development, although it has negative effects with E2 on endometrium in the pre-implantation period of rats.     

多力玛联合hCG治疗先兆流产临床研究

目的:探讨多力玛联合人绒毛膜促性腺激素(hCG)治疗黄体功能不全引起先兆流产的效果。方法:观察组采用多力玛联合hCG治疗;对照组采用单用hCG治疗,观察两组用药后激素变化及治疗效果。结果:用药后观察组β-hCG水平明显高于对照组。观察组保胎成功率明显高于对照组,两者有显著性差异(P<0.01)。结论:多力玛联合人绒毛膜促性腺激素(hCG)治疗黄体功能不全引起先兆流产有明显疗效。     

Dendritic polyglycerol nanoparticles show charge dependent bio-distribution in early human placental explants and reduce hCG secretion

A thorough understanding of nanoparticle bio-distribution at the feto-maternal interface will be a prerequisite for their diagnostic or therapeutic application in women of childbearing age and for teratologic risk assessment. Therefore, the tissue interaction of biocompatible dendritic polyglycerol nanoparticles (dPG-NPs) with first- trimester human placental explants were analyzed and compared to less sophisticated trophoblast-cell based models. First-trimester human placental explants, BeWo cells and primary trophoblast cells from human term placenta were exposed to fluorescence labeled, ～5?nm dPG-NPs, with differently charged surfaces, at concentrations of 1 µM and 10?nM, for 6 and 24?h. Accumulation of dPGs was visualized by fluorescence microscopy. To assess the impact of dPG-NP on trophoblast integrity and endocrine function, LDH, and hCG releases were measured. A dose- and charge-dependent accumulation of dPG-NPs was observed at the early placental barrier and in cell lines, with positive dPG-NP-surface causing deposits even in the mesenchymal core of the placental villi. No signs of plasma membrane damage could be detected. After 24?h we observed a significant reduction of hCG secretion in placental explants, without significant changes in trophoblast apoptosis, at low concentrations of charged dPG-NPs. In conclusion, dPG-NP’s surface charge substantially influences their bio-distribution at the feto-maternal interface, with positive charge facilitating trans-trophoblast passage, and in contrast to more artificial models, the first-trimester placental explant culture model reveals potentially hazardous influences of charged dPG-NPs on early placental physiology.     

Human chorionic gonadotrophin (hCG) enhances immunity against L. tropica by stimulating human macrophage functions

During pregnancy, there are important changes in hormone levels such as the huge production of human chorionic gonadotropin (hCG), which is supposed to influence the immune system. The aim of this study was to investigate the effect of hCG on immune response against Leishmania, through the evaluation of the functions of human macrophages infected with L. tropica. This study demonstrated that hCG significantly increased the NO production by rHu‐IFNγ‐primed macrophages then infected with L. tropica, which was correlated with decrease in the number of infected macrophages as well as the number of amastigotes per macrophage in a dose‐dependent manner; however, the greatest effect was shown with the 250 U/mL concentration. The addition of the same concentration of hCG to rHu‐IFNγ‐primed macrophages caused also a major increase in both IL‐6 and IL‐12p40 production. In conclusion, hCG enhances different macrophage functions involved in immunity against L. tropica.