Primary intravascular large B cell lymphoma of the endometrium

Primary intravascular large B cell lymphoma (IVLBCL) of the endometrium is extremely rare. So far, only 5 cases have been reported in the English literature. We now report a new case of endometrial IVLBCL which exhibited distinct clinicopathological characteristics and meaningful laboratory tests, and also review the literature. A 66-year-old woman showed symptoms of chronic cough and choking sensation for 4 months. Following three days of vaginal bleeding she presented for examination and diagnosis. The percentage of monocytes in the blood was double that of normal levels. There was a polyp in the endometrium, which showed a number of medium–large lymphoid cells in dilated capillaries. Immunohistochemically, the lymphoid cells were immunoreactive to CD20, CD79a, Mum-1 and Foxp-1 with 85% cells immunoreactive to Ki-67. IVLBCL of the endometrium is rare and the clinical diagnosis is very difficult. Unexplained fever of old people and abnormal laboratory tests such as obvious abnormal monocyte distribution in the blood should alert the clinical doctor to the possibility of IVLBCL. A correct diagnosis mainly depends on pathological tests and immunohistochemical labeling. The prognosis of IVLBCL is poor and few patients survive longer than one year.     

宫腔内人工授精HCG注射日血清雌孕激素比值、子宫内膜类型及厚度对妊娠的影响

目的探讨宫腔内人工授精HCG注射日血清雌孕激素比值、子宫内膜类型及厚度对妊娠的影响。方法分析了338例经促排卵后行人工授精治疗的患者注射HCG日雌孕激素的比值和子宫内膜的厚度、超声类型及妊娠结局。结果 338倒患者中,P／E2比值为0．5-2．0组临床妊娠率为30．05％,与<0．5组及>2．0组比较,均有显著性差异(P< 0．005);子宫内膜厚度为8-12mm组临床妊娠率为25．93％,分剐与<8mm组及>12mm组比较,均有显著性差异(P< 0．005和P<0．05);子宫内膜类型为A型组临床妊娠率为21．45％,分别与B型组及C型组比较,A、B两组无显著性差异(P>0．05),A、C两组有显著性差异(P<0．05)。结论在IUI治疗当中,特别是应用促排卵的IUI治疗中,围排卵期适宜的雌孕激素协同作用和子宫内膜厚度及类型对妊娠率的提高有重要意义。     

中医药在改善不同疾病子宫内膜容受性的应用

子宫内膜容受性是影响胚胎种植的重要因素之一,临床上多种疾病均可引起子宫内膜容受性下降,其影响的原因及机制也不同。中医根据不同疾病发病机制不同辨证论治,治疗以中药为主,结合针刺和腔内理疗可有效的调节改善子宫内膜从形态到分子到基因的一系列异常,可有效改善不同疾病的子宫内膜容受性。本文归纳整理了最近几年中医药提高不同疾病不孕患者子宫内膜容受性的方法及机制,并展开简要分析和探究,愿为其治疗提供一定的理论依据。     

沙眼衣原体感染对大鼠着床期间子宫内膜上皮细胞的影响

目的:研究沙眼衣原体(Ct)感染后大鼠着床期间子宫内膜形态学改变及肌动蛋白的变化。方法:大鼠雌雄合笼建立早孕模型,取正常妊娠组和Ct感染后妊娠组大鼠子宫,采用扫描电镜(SEM)观察子宫内膜超微结构改变及荧光免疫组化检测肌动蛋白的表达。结果:SEM示对照组子宫腔可见有微绒毛的分泌细胞;实验组腔上皮细胞表面有的可见破损,微绒毛少见;免疫组化结果显示荧光强度主要定位于腔上皮细胞胞质/胞膜,妊娠第4,5,6天沿胞质顶部分布较密集,而底部较弥散;妊娠第7天顶部强度有所增加;感染组的荧光强度均弱于相应正常组,在妊娠第5天存在显著性差异(P<0.05)。结论:沙眼衣原体感染后可能通过破坏子宫腔上皮分泌细胞,进而影响其内成分肌动蛋白,从而干扰早期妊娠。     

A preliminary study comparing the endometrial expression of inhibin, activin and follistatin in women with a history of implantation failure after IVF treatment and a control group

The aim of this study was to evaluate the expression of activin: beta A and beta B subunit and follistatin in endometrium of women with implantation failure ( n = 10) and compare it with a fertile control group ( n = 7). Immunohistochemical staining intensity for follistatin in the endometrial glandular epithelium from women with implantation failure were significantly lower than that in control women ( P = 0.03). The decreased expression of follistatin in epithelial cells in the endometrium of women with implantation failure after in vitro fertilisation (IVF) may suggest that follistatin may play a role in the implantation process.     

小剂量米非司酮治疗子宫肌瘤对子宫内膜的影响

目的观察米非司酮治疗子宫肌瘤对子宫内膜组织形态和内膜中雌激素受体（ER）、孕激素受体（PR）的影响。方法米非司酮组为20例临床诊断为子宫肌瘤合并不同程度贫血，有手术指征的患者，从月经第1天起给予米非司酮12．5mg／d口服，连续30d，第31～91天8mg／d口服。停药后立即手术；对照组为同期手术的36例未服用米非司酮的子宫肌瘤患者。两组手术后子宫标本均采用ER，PR单克隆抗体免疫组织化学法检测子宫内膜的ER，PR表达。结果米非司酮组子宫内膜以增殖期变化为主，内膜的ER，PR表达处于早、中增殖期水平。结论小剂量米非司酮治疗子宫肌瘤对子宫内膜是安全的，并不会增加其癌变倾向。     

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。     

产后小鼠子宫内膜边缘群干/祖细胞的分离纯化

目的分离和纯化小鼠子宫内膜边缘群(side population,SP)干/祖细胞,为进一步探讨产后子宫修复的细胞机制奠定基础。方法分别采用酶消化和机械分离结合法与机械研磨分离的方法,原代分离小鼠子宫内膜上皮细胞与基质细胞,通过Hoechst33342-SP法(对照加入维拉帕米),使用流式细胞仪检测子宫内膜SP细胞。结果未孕小鼠子宫内膜上皮与基质中均无明确SP干/祖细胞,产后哺乳期后的小鼠子宫内膜基质中含有SP干/祖细胞达(3.44±1.59)%。结论本研究初步检测到小鼠产后子宫内膜中含有SP干/祖细胞。产后更多SP细胞的出现可能与修复损伤的子宫内膜有关。这群SP细胞是子宫原位干细胞还是有其他来源,如何参与子宫内膜的修复,其分子机制如何,尚待进一步研究。     

The effect of Chinese herbal medicine“heche assisted pregnancy recipe”on endometrial estrogen and progesterone receptor,proliferating cell nuclear antigen and vascular endothelial growth factor in the patients with infertility

<正> Objectives.To investigate the effect of Chinese herbal medicine"heche assisted preg-nancy recipe (HCAPR)"on estrogen receptor(ER),progesterone receptor (PR),pro-lifierating cell nuclear antigen(PCNA) and vascular endothelial growth factor (VEGF)in endometrium of infertile women.Methods.The S-P immunohistochemical assay was used to observe expression ofER,PR ,PCNA and VEGF in late proliferative phase before and after the HCAPR treat-ment.Results.After the treatment,the expression of ER,PR,PCNA and VEGF in nucleiof glandular epithelium and stromal cells was significantly stronger (all P<0.001) re-spectively than that before treatment,especially the expression of PCNA and VEGF.Conclusions..These results suggest that traditional Chinese medicine HCAPR oftonifying kidney and regulating menstruation increased the synthesis of ER,PR,PCNAand VEGF,which may promote normal growth and development of the endometrium ,improve the micro-environment of the endometrium,and enhance uterine receptivity.The evidence may provide theoretical basis for therapy infertility with Chinese herbalmedicine.