盆底神经肌肉电刺激治疗薄型子宫内膜患者的临床研究

目的 探讨盆底神经肌肉电刺激(PFNES)治疗,对于薄型子宫内膜(TE)患者子宫内膜厚度(ET)与血流灌注及妊娠情况的影响.方法 选择2016年5月至2018年5月,在四川大学华西第二医院生殖医学科与生殖内分泌科接受门诊治疗、有生育需求的96例T E患者为研究对象.根据其是否接受PFNES治疗,将其分为研究组(n=51...     

Conditional relative survival of patients with endometrial cancer: a Korean National Cancer Registry study

ObjectiveThe purpose of this study was to estimate 5-year conditional relative survival (5Y CRS) rates of endometrial cancer (EC) in Korea accounting for time already survived. Subgroup-specific estimates stratified by various patient characteristics were also presented.MethodsUsing the data from the Korean Central Cancer Registry, 5Y CRS rates were calculated in patients who were diagnosed with EC between 1998 and 2017. The CRS rates were presented by year of diagnosis, age at diagnosis, histology, cancer stage, and treatment received.ResultsThe 5-year relative survival rate at the time of diagnosis was 89.0% for all cases. The probability of surviving an additional 5 years (i.e., 5Y CRS), if the patient survived 1, 2, 3, 4, and 5 years after diagnosis was 91.8%, 94.1%, 95.6%, 96.5%, and 97.3%, respectively. Patients with poor initial prognoses, i.e., those who were older, had non-endometrioid histology, and high stage, showed the largest improvements in 5Y CRS, reaching >90% for most subgroups, except those with serous histology (88.4%) and distant stage (77.7%). Patients aged ≥70 years had the highest probability of death in the 1st and 2nd years after diagnosis (13.8 and 11.0%), but the conditional probability of death in the 3rd, 4th, and 5th years declined rapidly to 7.3%, 4.5%, and 3.7%, respectively.ConclusionThe CRS rates for patients with EC improved with increased time elapsed from diagnosis. The greatest improvements in 5Y CRS were observed among patients who were older, those with non-endometrioid histology, and those with more advanced disease.     

3D打印个体化模具在子宫内膜癌术后三维后装治疗中的剂量学研究

目的 探讨3D打印个体化模具辅助子宫内膜癌术后三维后装治疗中的剂量学优势。方法 回顾性选取宁波大学附属第一医院21例早期子宫内膜癌术后患者的三维后装治疗计划,利用北京科霖众计划系统,在已实施的个体化模具组基础上,为每位患者设计虚拟单通道柱状施源器计划,所有计划均采用三维逆向模拟退火的算法。比较两组计划靶区90%、98%和100%体积接受的最低剂量(D₉₀、D₉₈、D₁₀₀)以及适形指数(CI)、均匀度(HI)、超剂量体积指数(OI);同时,对比两组危及器官膀胱、直肠、小肠和尿道的0.01、1、2以及5 cm³所接受的最大剂量(D_{0.01 cm³}、D_{1 cm³}、D_{2 cm³}以及D_{5 cm³})差异。结果 两组计划都能满足临床需求。在靶区所受剂量方面,两组计划靶区D₉₀、D₉₈、D₁₀₀没有明显差异,但是个体化模具组靶区剂量的CI、HI均优于单通道组靶区,而靶区OI指数小于单通道计划(t=-3.21、-5.99、6.25,P＜0.05)。在危及器官所受剂量方面,个体化模具组膀胱、直肠、尿道所受剂量D_{1 cm³}、D_{2 cm³}和D_{5 cm³}相比单通道组均有明显降低(t=3.18、3.21、3.77、7.97、8.92、10.92、2.54、3.46、4.28,P＜0.05);小肠由于距离靶区比较远,在两组计划中所受剂量差异不明显(P＞0.05)。结论 3D打印个体化模具在子宫内膜癌术后三维近距离治疗中靶区均匀度、适形指数更优,而且膀胱、直肠、尿道所受剂量更低,具有推广价值。     

经阴道彩超对子宫内膜癌肌层浸润程度和病理分期的诊断效果研究

目的:探讨经阴道彩超对子宫内膜癌Ⅰ期肌层浸润程度的诊断效果。方法:选取我院2015年收治的子宫内膜癌Ⅰ期患者72例,均进行经阴道彩超检查,分析患者的肌层浸润程度。结果:分级越高的患者肌层的浸润程度更厉害(P0.05),淋巴结转移患者的子宫浸润程度更厉害(P0.05),经阴道彩超筛查子宫内膜癌患者的肌层浸润灵敏度是84.0%,特异度是89.4%,经阴道彩超同病理分期的诊断符合率是72.2%。结论:子宫内膜癌Ⅰ期患者使用经阴道彩超进行诊断的效果比较可靠,并且费用低廉、操作简便,能够为临床上患者的早诊断以及早治疗提供依据,从而改善治疗的效果。     

Genetic basis for remating inDrosophila melanogaster. III. Correlated responses to selection for female remating speed

Two natural populations ofDrosophila melanogaster selected for fast and slow female remating (Gromko and Newport,Behav. Genet.18: 621–632, 1988) were analyzed for correlated responses to selection. Several of the correlated responses differed between the lines derived from the two different source populations. In particular, the degree to which female receptivity to remating was dependent on the number of sperm in storage ceptivity to remating was dependent on the number of sperm in storage remained high in one pair of fast and slow selected lines but not in the other. In the line which retained sperm dependence (JEFFERS), fast and slow remating was achieved by changes in the threshold at which remating occurred. In the other line (COMP) changes in the temporal pattern of sperm use were seen. Thus both the level of the receptivity threshold and the existence of a sperm effect appeared to be selectable features of this species. Mated female attractiveness and receptivity were shown to be genetically distinct from virgin female attractiveness and receptivity. Effects of the genotype of the female on copulation duration were found.This work was supported by NSF Grants 82-01183 and 84-18934.     

Expression of Blood Group Antigens and Lectin Binding in Adenocarcinomas of the Endometrium

To investigate cytoplasmic alterations in cancers of the endometrium, monoclonal antibodies against H, A and B blood group substances and related lectins such as Ulex europaeus agglutinin 1 (UEA-l), Lotus fefragonolobus agglutinin (LTA), and Griffonia simplicifolia 1 (GS1-A4, -B4) were applied to 42 cases of endometrial adenocarcinoma (EAC) and 11 adenomyoses. The control specimens consisted of normal endometria with leiomyoma or adenomyosis from patients of known blood group type. The brightest and most consistent staining was obtained with GS1- A4, showing 98% positivity in EAC in contrast to 18% in normal endometria. In contrast, expression of A antigen was seen in only 24% of EAC and in 13% of normal endometria, UEA-1 binding was seen in 81% of EAC and in 10% of normal endometria, whereas H antigen was seen in 60% of EAC and 0% of normal endometria. In adenocar. cinomas, staining was seen not only along the luminal border of glands but also in the cytoplasm and the lateral or basal cell membranes, whereas in the normal endometrium staining was mostly along the luminal border. Thus, a difference in the positivity and localization of glycoconjugates was observed in neoplastic and non neoplastic endometrium.     

子宫内膜癌合并子宫内膜异位症的临床病理分析

目的通过对子宫内膜癌合并子宫内膜异位症的临床病理分析,探讨子宫内膜异位症和子宫内膜癌的内在联系。方法将2011年3月～2012年9月在我院治疗过的患有子宫内膜癌合并子宫内膜异位症的病例数34例作为组1．同时将患有子宫内膜癌但未合并子宫内膜异位症的78例作为组2,将仅患有子宫内膜异位症的44例作为组3。根据临床病理特征和年龄分布从而对三组进行对照分析。结果组1和组3的病理分期相对于组2的病理分期均较低,且患者年龄均趋向于年轻化,三组的年龄分布以及手术病理分期经比较,差异有统计学意义（P〈0．05）。结论当病例同时患有子宫内膜异位症时,病例趋向于年轻化,子宫内膜癌的病理分期较早,细胞分化较高同时肌层浸润浅,病情恢复快。     

超声子宫内膜类型和厚度在异位妊娠鉴别诊断中的作用

目的：本研究旨在了解子宫内膜三线型和厚度在异位妊娠诊断中的作用。方法：回顾性分析疑为异位妊娠病人的临床资料和超声表现,检验子宫内膜三线型和厚度在异位妊娠诊断中的预测作用。结果：三线型有94.8%的特异性和38.1%的敏感性（487例）,异位妊娠病人的平均内膜厚度较正常妊娠者薄（9.5±5.7mmVS12.5±5.9mmP〈0.05）。正常妊娠和早期流产病人子宫内膜厚度相似（12.5±5.9mmVS12.4±5.6mm）。接受操作曲线显示子宫内膜厚度对于异位妊娠诊断无使用价值。结论：三线型对异位妊娠诊断有特异性,但敏感性低,异位妊娠病人子宫内膜趋向于较薄。     

Adjuvant radiation therapy is associated with improved overall survival in high-intermediate risk stage I endometrial cancer: A national cancer data base analysis

Purpose

Adjuvant radiation therapy (RT) was shown to improve local control in patients with high-intermediate risk (HIR) stage I endometrial cancer (EC) in randomized trials. Overall survival (OS) was not significantly different with adjuvant RT in these trials or subsequent meta-analyses; however, they were underpowered to assess OS. We used the National Cancer Data Base (NCDB) to examine the impact of adjuvant RT on OS in HIR EC patients.