达因35联合小剂量地塞米松治疗多囊卵巢综合征的效果分析

目的：通过观察达因35联合小剂量地塞米松治疗多囊卵巢综合征（ PCOS）的临床效果,探讨PCOS高雄激素血症的有效治疗途径。方法将68名高雄激素血症性PCOS患者随机分为两组,分别给予口服达因35（达因组）和达因35联合小剂量地塞米松（地塞米松组）治疗3～6个周期,比较治疗前后PCOS患者多毛痤疮、肥胖指数、卵泡发育和排卵率以及血清激素的变化,并进行统计学分析。结果达因35和达因35联合小剂量地塞米松能够明显降低PCOS患者体内促黄体生成素（ LH）、游离睾酮（ FT）、雄烯二酮（ A）、硫酸脱氢表雄酮（DHEA－S）、17－羟孕酮（17－OHP）的水平,治疗3个周期地塞米松组显著低于达因组（P＜0.01）,治疗6个周期两组比较差异无显著性（ P＞0.05）;治疗3个周期达因35联合小剂量地塞米松可明显改善PCOS患者多毛、痤疮、卵泡发育和排卵率,与达因组比较差异有显著性（ P＜0.05）。结论小剂量地塞米松可协同达因35治疗PCOS高雄激素血症并明显缩短达因35的治疗周期,同时显著改善高雄激素血症引起的慢性无排卵、多毛痤疮等临床症状。     

卵巢性索间质肿瘤的CT表现与病理对照研究

目的 探讨卵巢性索间质肿瘤的CT表现并与术后病理进行对照分析,以提高术前诊断水平.方法 回顾性分析23例经手术病理证实的卵巢性索间质肿瘤的临床资料、CT表现、术后病理,对颗粒细胞瘤与卵泡膜细胞瘤-纤维瘤的平扫CT值与增强后强化程度ACT值进行比较分析.结果 (1)颗粒细胞瘤7例;(2)卵泡膜细胞瘤3例、纤维-卵泡膜纤维瘤11例12枚;(3)Sertoli-Leydig细胞瘤1例;(4)类固醇细胞瘤1例,在CT上具有一些特征性表现,且与术后病理相对应.颗粒细胞瘤与卵泡膜细胞瘤-纤维瘤的平扫CT值无明显差异(t=1.487,P=0.157),颗粒细胞瘤增强后强化程度△CT值较卵泡膜细胞瘤-纤维瘤高(t=2.528,P=0.041).结论 卵巢性索间质肿瘤具有一定的CT特点,符合其病理表现,结合临床资料,有助于术前初步诊断.     

子宫动脉栓塞术:两种栓塞剂对卵巢功能影响的对比研究

目的:探讨超液化碘化油、平阳霉素混合液在子宫肌瘤栓塞术中对卵巢功能的影响.方法:将83例子宫肌瘤患者分成两组进行栓塞治疗,其中A组(42例)采用聚乙烯醇微粒(直径500～700μm)作为栓塞剂,另外B组(41例)采用超液化碘化油和平阳霉素混合液作为栓塞剂.观察栓塞前后血清FSH、LH、E2水平变化及并发症发生的情况.结果:两组栓塞前及栓塞后3个月、6个月血清性激素变化没有统计学差异(P>0.05),B组出现1例永久性闭经及1例膀胱损伤.结论:从近期追踪观察来看聚乙烯醇和碘油、平阳霉素混合液两种栓塞剂在子宫肌瘤栓塞中对卵巢功能的影响没有统计学差异,但因为碘油的液体特性,一旦发生误栓易出现严重并发症,因此应慎重选择.     

Protective effects of dexmedetomidine in pneumoperitoneum-related ischaemia–reperfusion injury in rat ovarian tissue

Objectives

To determine the effects of dexmedetomidine on pneuomoperitoneum-related ischaemia–reperfusion (I/R) injury in rat ovarian tissue.

Study design

Animals were randomized into three groups: Group S (n = 8), no pneumoperitoneum; Group C (n = 8), pneumoperitoneum; and Group D (n = 8), 100 μg intraperitoneal dexmedetomidine 30 min before pneumoperitoneum. Ovarian tissue was collected from all rats 30 min after desufflation, and fresh frozen for histological and biochemical evaluation.

Results

Body weight was similar in all three groups (202.62 ± 28.86, 211.00 ± 14.45 and 212.87 ± 15.71 g in Groups S, D and C, respectively). The mean malondialdehyde level was higher in Group C than the other groups (p < 0.03). When the histological samples of ovarian tissue were compared, vascular congestion, haemorrhage, follicular cell degeneration and infiltrative cell infiltration scores were higher in Group C compared with the other groups (p < 0.05). Significantly lower scores for the histological parameters were found in Group D compared with Group C (p < 0.05). Similar scores for follicular cell degeneration and inflammatory cell infiltration were found in Group D and Group S (p > 0.05). Although vascular congestion and haemorrhage scores were significantly lower compared with Group C, higher scores were found for Group D compared with Group S (p < 0.05).

Conclusion

Pneumoperitoneum caused oxidative injury in rat ovarian tissue. Dexmedetomidine reduced oxidative stress and histological injury related to I/R.     

Urinary 6-sulfatoxymelatonin excretion in hyperandrogenic women with polycystic ovary syndrome: the effect of ethinyl estradiol–cyproterone acetate treatment

The role of melatonin in human reproduction is still unknown. Data obtained in patients with hypogonadism and precocious puberty suggest that melatonin and the reproductive hormones are interrelated.The aim of this study was to determine melatonin production in hyperandrogenic women. We studied 12 women with polycystic ovary syndrome (PCOS) and 10 women with idiopathic hirsutism (IH). Patients were treated with cyproterone acetate–ethinyl estradiol (Diane 35) for 4 months. Fasting blood samples for the determination of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone and dehydroepiandrosterone sulfate (DHEAS) and 24-h urine collections for the determination of 6-sulfatoxymelatonin (αMT6s) excretion were obtained from all patients at baseline and after 4 months of treatment. The results were compared with those obtained in 15 control women. At baseline, women with PCOS had significantly higher LH and testosterone levels than those with IH and controls. Their αMT6s values (52.6?±?20.3?µg/24?h) were significantly higher than the values in women with IH (34.3?±?7.1) and controls (30.5?±?6.5) (p?<?0.001). Diane 35 treatment significantly decreased LH, FSH, testosterone and αMT6s values in PCOS (28.0?±?13.9?µg/24?h) (p?<?0.0001). These results indicate that women with PCOS have increased melatonin production. The normalization of αMT6s and testosterone values during Diane 35 treatment suggests that sex steroids modulate melatonin secretion in these patients either directly or through the suppression of gonadotropin.     

多模态MRI对子宫恶性中胚叶混合瘤的影像学特征与病理对照的分析

目的 探讨多模态MRI对子宫恶性中胚叶混合瘤(MMMT)的影像学特征与病理对照的关系,以提高对该病的认识及诊断准确率.方法 选取28例经手术病理证实MMMT患者的临床资料,讨论分析临床特点、MRI平扫+联合动态增强(DCE-MRI)及弥散加权像成像DWI(ADC值)检查、病理学及免疫组化检查.结果 MMMT癌成分为子宫...     

Ovarian Mass Mimicking Malignancy: A Case Report

A 32-year-old female who suffered from abdominal pain underwent ¹⁸F-fluorodexoyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the diagnostic workup of pelvic mass lesions. Cystic mass lesions in the bilateral ovaries showed wall thickening and intense hypermetabolism along the rim. In addition, multifocal intense hypermetabolic lymphadenopathies were seen in the left paraaortic lymph node (LN), aortocaval LN, and both common iliac LNs. We interpreted these findings as bilateral ovarian cancer with retroperitoneal metastatic lymphadenopathies rather than endometriosis with reactive lymphadenopathies. However, histopathological examination confirmed the ovarian mass lesions as tubo-ovarian abscesses. We report a case that even if simultaneous hypermetabolic retroperitoneal LNs are seen, intense hypermetabolic lesions in both ovaries can be in consequence of inflammatory change.     

Incidental ovarian 18F-FDG accumulation on PET: correlation with the menstrual cycle

Purpose The aim of this study was to determine the nature of incidental ovarian ¹⁸F-fluoro-2-deoxyglucose (FDG) accumulation on positron emission tomography (PET) and the correlation with the menstrual cycle and menopause.Methods We identified 19 incidental FDG accumulations in the ovary (FAOs). FDG PET images were compared with other anatomical imaging methods [magnetic resonance imaging (MRI), computed tomography (CT) or ultrasonography (US)]. Pathological findings, FDG PET scan during the next menstrual cycle and follow-up images (PET, CT and MRI) were reviewed. To establish the relation of FAOs to the menstrual cycle, we reviewed whole-body FDG PET acquired from 207 consecutive women and the pre-examination questionnaires, including data regarding the menstrual cycle.Results All spherical or discoid FAOs were attributed to normally developing ovarian follicles and corpora lutea on the basis of concurrent MRI, US or the follow-up PET scan. Three of the FAOs were proved pathologically to be either normal ovaries or a haemorrhagic corpus luteum. Fifteen FAOs spontaneously disappeared on the short-term follow-up PET scans. Of 207 women, 61 had active menstrual cycles. FAOs were found in 12 out of 61 premenopausal women (20%), appearing between the 10th and 25th days of the menstrual cycle. No FAOs were found in the women who did not have a menstrual cycle.Conclusion Physiological ovarian FDG accumulation could be found around the time of ovulation and during the early luteal phase of the menstrual cycle in premenopausal woman. Since FAO is dependent on the menstrual cycle, it can be avoided by scheduling PET just after menstruation.     

卵巢卵泡膜细胞瘤的CT诊断

目的:探讨卵巢卵泡膜细胞瘤的CT特点,提高对本病的CT诊断水平.方法:分析7例经手术病理证实的卵巢卵泡膜细胞瘤患者的临床资料和CT表现.结果:7例中肿瘤位于右侧附件区5例,左侧附件区2例.6例(6/7)表现为边界清楚的圆形、卵圆形实质性肿块,1例表现为边界清楚的分叶状实质性肿块,密度均与子宫肌层相近,病灶与子宫和肠腔分界清晰,5例肿瘤内可见散在小片状低密度区;增强扫描示肿瘤在实质期和延迟期呈缓慢渐进性轻度强化,5例肿瘤较大,其内散在小片状低密度区未见强化.7例中合并腹水6例,合并囊腺瘤、单发子宫肌瘤、多发子宫肌瘤各1例.结论:卵泡膜细胞瘤的CT表现有一定特征性,CT对本病的诊断和鉴别诊断有重要价值.