子宫内膜癌中p16、E-cad mRNA表达的研究

目的 :探讨p16及E 钙粘附蛋白 (E cad)基因mRNA在子宫内膜癌中的表达及意义。方法 :采用RT PCR技术检测 3 0例子宫内膜癌及 8例正常子宫内膜组织的p16及E cadmRNA的表达。结果 :①子宫内膜癌p16mRNA的阳性表达明显低于正常子宫内膜 (P <0 .0 1) ,但p16mRNA的表达与子宫内膜癌的组织病理分级无关 ;②E cadmRNA在子宫内膜癌中呈低表达 ,正常组织内呈强阳性表达 ,二者差异非常显著 (P <0 .0 1) ,并且在子宫内膜癌中E cadmRNA的阳性表达与组织病理学分级呈负相关 (P <0 .0 5 )。结论 :p16、E cadmRNA的表达在子宫内膜癌的发生及进展过程中起重要作用     

51例老年子宫内膜癌临床分析

目的 :分析老年子宫内膜癌的临床特点、病理类型及处理方法 ,以期进一步指导临床治疗。方法 :对 131例子宫内膜癌患者中≥ 6 0岁 5 1例 (老年组 )进行回顾性研究并与同期≤ 5 0岁的 35例 (中青年组 )做对照分析。全部手术切除的标本均经病理检查确诊。结果 :老年组与中青年组临床分期 ,Ⅱ期以上的分别为 2 9 4 %(15 / 5 1)和 11 4 %(4/ 35 ) ;组织分级G2 -G3分别为 6 8 6 %(35 / 5 1)和 45 7%(16 / 35 ) ;子宫肌层浸润深度大于 1/ 2的分别为 43 1%(2 2 / 5 1)和 2 0 0 %(7/ 35 ) (P <0 0 1) ;5年存活率分别为 6 6 6 %和 91 4 %(P <0 0 5 )。结论 :老年子宫内膜癌的预后较中青年妇女的子宫内膜癌差 ,与临床分期晚和组织分化差有关。     

挑刺阳性反应点治疗腰椎骨质增生38例

试用三棱针挑刺腰部阳性反应点,治疗腰椎骨质增生38例,结果有效率100%,具有疗效好,费用低,疗程短,应用方便的特点.     

子宫内膜癌147例临床分析

目的：探讨子宫内膜癌的治疗及预后相关因素。方法：回顾性分析我科1991～1997年收冶的147例子宫内膜癌患者的临床病理资料，并全部随访。结果：147例患者、平均年龄56．1岁；5年生存率72．8％；临床表现不规则阴道出血135例、盆腔包块81例、白带增多38例及腹痛23例；绝经前病例为39．5％，已占相当比例，有年轻化趋势；临床病理分期愈晚，预后愈差；肌层侵犯的深度与淋巴结转移及病理组织学分级密切相关，深肌层浸润者，易淋巴结转移、病理组织学分级也差；手术为主、放疗、化疗为辅助治疗的综合治疗预后好、并发症少；孕激素对改善预后有一定的价值。结论：以手术为主的综合治疗是目前治疗子宫内膜癌的首选治疗措施；绝经前后的妇女出现不规则阴道出血等非特异性的妇科症状时，必须警惕子宫内膜癌的发生；临床病理分期、肌层浸润深度、病理组织学分级、淋巴结转移情况及孕激素的应用都是影响预后的相关因素。     

B(a)P诱导小鼠前胃癌过程中组织病理学变化

目的：探讨B(a)P诱导小鼠前胃癌过程中胃组织形态学的动态改变。方法：小鼠用5mg／ml的B(a)P灌胃，每周两次，共4周。以后每隔4周处死一部分小鼠，对胃组织进行病理组织学观察。结果：从第17周开始小鼠前胃开始出现肉眼可见的肿瘤，前胃组织由局部腺体增生、排列紊乱逐步发展为腺体普遍异常增生，形成早期胃癌，进一步发展出现进展期胃癌。结论：B(a)P诱导的小鼠前胃癌的潜伏期大约3个月左右，前胃组织病理学动态变化过程是萎缩性胃炎、不典型增生、胃癌。     

Outcome of congenital adrenal hyperplasia

In congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, affected girls are born with ambiguous genitalia due to increased secretion of androgens in utero by the defective adrenal gland. Even though it is generally accepted that there are differences between male and female brain development, determining factors have been difficult to identify. Girls with CAH have frequently been studied to evaluate the impact of prenatal androgen exposure on psychological, psychosocial, and psychosexual development, and impairments in various areas have been identified. However, there is no comprehensive study available regarding the outcome of this chronic disorder in adult life. We studied the quality of life in women with CAH, with particular emphasis on how they cope with genital malformations, genital operations, and chronic disease as well as lifelong medication. The patients filled out questionnaires covering their physical state, psychological well-being, social relationships, and functional capacity, as well as questionnaires on psychosexual identification and psychosocial integration. The results were evaluated using a computerized statistical program for social studies. Out of a total of 94 patients above 18 years of age, 45 agreed to participate and were compared to 46 healthy, age-matched controls. Age at diagnosis was 2.31 ± 1.55 years and 38% suffered from the simple-virilizing, 45% from the salt-wasting, and 17.0% from the late-onset form of CAH. About one-third of patients had Prader stage 3 or 4 genital virilization. While the overall quality of life did not differ significantly, CAH patients were more often single (47.8% vs. 66.7%) and fewer of them had children (22.2% vs. 38.6%) compared to controls. Significant impairments were found in regard to body image and attitudes toward sexuality, but there was no increased homosexual preference. The women were successful in adjusting to illness and receiving social support. It is speculated that improved psychosocial adaptation is part of a coping mechanism that helps to maintain a high level of well-being despite impairment. Coping mechanisms should be identified and strengthened in order to help patients cope with their chronic illness.     

孕激素治疗子宫内膜癌的形态学观察与治疗机理探讨

目的：通过孕激素对子宫内膜腺癌治疗后的形态观察，而探讨其治疗机理。方法：对我院经孕激素治疗并手术切除的４２例子宫内膜腺癌标本及３４例未用孕激素治疗的子宫内膜腺癌诊刮标本，进行光镜、电镜的腺癌细胞形态学观察。结果：孕激素治疗后的腺癌细胞分化趋向成熟，其分泌活跃，同时，还在癌组织中观察到凋亡的腺癌细胞。未经孕激素治疗的子宫内膜腺癌细胞，其组织排列紊乱，极性消失，有些腺体呈背靠背现象。结论：孕激素对肿瘤细胞有直接作用，使癌细胞生长受抑，促使其分化转向成熟，术前与术后应用孕激素治疗，可减少腹腔种植及转移，减少术后复发机会。     

Effect of peritoneal fluid from patients with mild and severe endometriosis on endometrial stromal cell proliferation

The aim of this study was to evaluate and compare the mitogenic effect of peritoneal fluid (PF) from women with mild and severe endometriosis on the endometrial stromal cell proliferation. Increasing concentrations of PF from women with and without mild or severe endometriosis were added to primary endometrial stromal cell cultures and³H-thymidine incorporation was used to assess DNA synthesis in these cultures. PF from women with mild endometriosis induced a statistically significant dose-dependent increase in stromal cell thymidine uptake ranged from 5.8 to 14.5 fold, whereas PF from women with severe endometriosis produced an average 51% inhibition of stromal cell proliferation of compared with cells exposed to non-endometriosis PF or exposed to nutrient medium supplemented with 2.5% calf serum alone. PF samples from patients with stage I endometriosis induced a statistically dose-dependent increase in stromal cell proliferation, whereas PF from patients with stage IV endometriosis caused a significant inhibition.     

182例子宫内膜癌的疗效分析

目的：探讨子宫内膜癌的疗效从其预后因素。方法;收集1979年4月至1991年4月随访资料完整的182例子宫内膜癌。全组病人均经手术及术前放疗，部分病人术后放疗。经统计学X2检验分析预后。结果：总5年生存率80.2％，Ⅰ期91.9％，Ⅱ期81％，Ⅲ期56％，Ⅳ期0，临床分期、病理类型、组织学分级、宫体肌层浸润盆腔淋巴结转移是影响预后的重要因素、结论;术前分段诊刮至关重要、放宽1期病例下术指征是提高Ⅰ期盆腔淋巴结转移病例存活率的关键，术前术后放疗是防止复发提高存活率的有效措施。