C型凝集素样受体CLEC-2在人滋养细胞系HTR-8/SVneo的表达与调控

目的研究C型凝集素样受体CLEC-2在人早孕期母胎界面滋养细胞的表达及调控。方法应用免疫细胞化学法和Western blot法检测人滋养细胞系HTR-8/SVneo中CLEC-2的表达;并观察不同浓度人绒毛膜促性腺激素（hCG）、孕激素及雌激素对其表达CLEC-2的影响。结果 HTR-8/SVneo显著表达CLEC-2。与对照组相比,2.5和5.0kU/LhCG处理组CLEC-2的表达上调;相反,经0～10-7mol/L浓度雌激素处理后,HTR-8/SVneo中CLEC-2的表达呈剂量依赖性降低;孕激素不影响CLEC-2的表达。结论 HTR-8/SVneo表达CLEC-2受hCG升调节、雌激素降调节;CLEC-2可能参与调节人早孕期滋养细胞的生物学行为,进而参与正常妊娠的维持。     

Prostaglandin dehydrogenase (PGDH) in granulosa cells of primate periovulatory follicles is regulated by the ovulatory gonadotropin surge via multiple G proteins

The ovulatory gonadotropin surge increases granulosa cell prostaglandin synthesis as well as prostaglandin dehydrogenase (PGDH), the key enzyme responsible for prostaglandin metabolism. To investigate gonadotropin regulation of PGDH in the primate follicle, monkey granulosa cells were obtained across the 40-h periovulatory interval. PGDH activity was low before the ovulatory hCG stimulus, peaked 12-24 h after hCG, and was low again 36 h after hCG administration. Granulosa cells maintained in vitro with hCG showed a similar temporal pattern of PGDH. The LH/CG receptor can utilize multiple signaling pathways to regulate intracellular events. Gonadotropin-stimulated cAMP appears to act primarily via the Epacs to increase PGDH mRNA, protein, and activity. In contrast, PLC activation of PKC likely decreases PGDH mRNA, protein, and activity late in the periovulatory interval. Increased, then decreased PGDH activity may delay accumulation of prostaglandins in the follicle until late in the periovulatory interval, contributing to timely ovulation in primates.     

Efficacy of Low-Dose Human Chorionic Gonadotropin (hCG) in a GnRH Antagonist Protocol

Purpose: To examine the efficacy of low-dose hCG using a GnRH antagonist protocol. Methods: Prospective randomized study was performed at the Kyono Ladies Clinic. One hundred ninety-two women (<40 –years old, <3 previous cycles) were randomly assigned to GnRH agonist (buserelin) long protocol (LP, n = 66), GnRH antagonist (cetrorelix) with no low-dose hCG protocol (NhCGP, n = 63), or GnRH antagonist with low-dose hCG protocol (hCGP, n = 63). Results: The hCGP was associated with reduced total amounts of FSH, increased oocyte maturation rate, high-quality day 3 embryos rate, and number of frozen embryos. Ovarian hyperstimulation syndrome (OHSS) tended to be lower in the GnRH antagonist protocol. Pregnancy and implantation rates did not differ significantly between study groups. Conclusions: Daily low-dose hCG supplementation in the late follicular phase could improve the outcome in FSH based-GnRH antagonist protocol. This protocol, however, does require further modifications, including determination of the optimal doses for hCG and gonadotropin pretreatment.     

输卵管妊娠根治术后持续性异位妊娠6例临床分析

目的：探讨输卵管妊娠根治术后持续性异位妊娠的原因及诊治。方法分析2003年1月1日至2014年9月30日杭州师范大学附属医院输卵管妊娠根治术后发生的6例持续性异位妊娠病例的诊疗过程。结果输卵管妊娠根治术后持续性异位妊娠病例占同期输卵管妊娠根治病例的1.6%。患者平均年龄(27.4±5.7)岁,平均停经时间(45.3±6.7)天;6例均为流产型或破裂型;术前血人绒毛膜促性腺激素(hCG)平均(10476.2±13874.3) IU/L,术后3天血 hCG 降幅平均为(79.7%±17.9%),血hCG最低平均(493.1±891.4)IU/L,再次上升的时间平均为术后(18.5±5.9)天;6例中有4例单用甲氨蝶呤(MTX)药物治疗,另2例MTX联合米非司酮治疗,两种治疗方法均治愈患者,疗效上无显著性差异(t=0.298,P>0.05)。结论输卵管妊娠根治术后持续性异位妊娠的发生与术前血hCG的高低、输卵管妊娠的类型、手术方式等相关,术后严密监测血hCG非常必要。