Laparoscopically assisted full thickness skin graft for reconstruction in congenital agenesis of vagina and uterine cervix

In patients with agenesis of the vagina and cervix but with a functional endometrium, the traditional treatment is hysterectomy with construction of a neovagina. We report successful treatment by laparoscopically assisted full thickness skin graft for reconstruction in a patient with congenital agenesis of the vagina and uterine cervix concomitant with haematometra and ovarian endometrioma in a 12 year old girl. Postoperatively, the vaginal skin graft healed well, and menstruation first appeared 4 weeks later. In our opinion, a combined laparoscopic and vaginal procedure with full thickness skin graft is an efficacious alternative in managing such genital defects.     

广州地区女性生殖道支原体感染及其药敏状况

目的： 了解广州地区女性生殖道支原体感染及药敏状况及其临床意义。方法：收集我院妇科门诊５４３ 例宫颈分泌物标本进行支原体培养及药敏分析。结果：本院妇科门诊生殖道支原体感染率６０．８％ ;其中,解脲脲原体感染占６８．９％ ;新一代大环内酯类药及喹诺酮类药对解脲脲原体的敏感性较高;支原体混合感染可使其耐药性提高６～１２ 倍。结论：宫颈分泌物支原体阳性标本的药敏试验有助于本地区妇科门诊合理用药,减少盲目性。     

氟苷双层单向缓释膜的研制及质量考察

研制一种子宫颈给药的双层单向缓释膜剂并建立其质量控制方法,拟为临床治子宫颈癌提供一种新型给药方式。以氟苷为模型药物,ＰＶＡ：ＳＣＭ（１：１）为含药膜基质,卡波姆－９４０为缓释材料,ＰＶＣ为覆盖材料制膜。紫外分光光度法测定主药含量,并进行均匀度实验、稳定性试验、用静态小室进行单向释药试验,并考察本品体内外释药特性,判断体内外释药相关性。结果表明：氟苷在ＰＨ５．０乙酸钠缓冲液中,在２６８．６ｎｍ处有吸     

宫颈癌盆腔淋巴结转移相关因素分析

目的 :了解子宫颈癌盆腔淋巴结转移的相关因素。方法 :对 3 0 5例ⅠA～ⅡB期宫颈癌行根治术的临床资料进行回顾性分析。结果 :ⅠA期宫颈癌盆腔淋巴结转移率 0 ,ⅠB期为 9 8% ,ⅡA期为 18 5 2 % ,ⅡB期为 5 7 14 % ;宫颈鳞癌盆腔淋巴结转移率为 8 2 % ,宫颈腺癌为42 2 7% ;宫颈癌高分化组盆腔淋巴结转移率为 0 ,中分化组为 11 16% ,低分化组为 40 62 % ;宫颈间质浸润深度 <1/ 2组盆腔淋巴结转移率为 1 2 3 % ,≥ 1/ 2组为2 1 88% ;宫颈癌糜烂型盆腔淋巴结转移率为 17 0 2 % ,外生型为 13 95 % ,内生型为 18 5 2 % ,溃疡型为 41 67% ;宫颈肿瘤≥ 4cm者盆腔淋巴结转移率为 2 0 0 % ,<4cm者为 12 14 % ;手术前予化疗者盆腔淋巴结转移率为 7 4% ,未行化疗者为19 5 6% ;手术前行放疗者盆腔淋巴结转移率为 4 76% ,未行放疗者为 19 5 6%。结论 :宫颈癌患者的临床分期、病理分级、组织类型、宫颈间质浸润深度、生长方式及术前化疗或放疗与盆腔淋巴结转移有直接关系 ,而肿瘤大小与盆腔淋巴结转移关系不明显。     

宫颈癌患者外周血Th1/Th2细胞因子表达水平的研究

目的 :分析 2 7例宫颈癌患者外周血单个核细胞 (PBMC)中Th1/Th2 两类细胞因子的表达水平 ,并与正常人比较 ,了解宫颈癌患者的免疫漂移现象。方法 :利用RT PCR技术检测 2 7例宫颈癌患者PBMC中Th1/Th2 两类细胞因子的mRNA表达水平。结果 :2 7例宫颈癌中IFN γ、IL 2、IL 4、IL 6和IL 10的表达阳性率依次为2 /2 7、3 /2 7、18/2 7、14 /2 7和 18/2 7。结论 :宫颈癌患者高表达Th2 类细胞因子 ,低表达Th1类细胞因子 ,出现典型的Th2 漂移现象 ,为宫颈癌的生物治疗提供可能。     

Human papillomavirus type 18 DNA sequences in adenocarcinoma and adenosquamous carcinoma of the uterine cervix

Human papillomavirus (HPV) DNA sequences were detected by Southern blot hybridization and polymerase chain reaction (PCR) in 10 out of 19 patients (52.7%) with adenocarcinoma [15] and adenosquamous [4] carcinoma of the uterine cervix. HPV 18 DNA was detected in 8 of these 19 patients (42.1%), HPV 16 DNA in 1 patient (5.3%) and HPV type X (unknown) in another (5.3%). Of the 10 HPV positive samples HPV 18 was found in 6 out of 6 pure adenocarcinomas (100%), and in 2 of 4 (50%) adenosquamous carcinomas. HPV 16 and HPV X were each detected in 1 out of 4 (25%) adenosquamous carcinomas. The physical state of the viral DNA was investigated in 5 of the 10 HPV-positive cases. All the specimens from these 5 cases showed HPV to be integrated into the host genome, except for one adenosquamous specimen, which showed both episomal and integrated forms of HPV 16. Six of 8 HPV 18 DNA positive specimens were from cases of pure adenocarcinoma and it was found by PCR that five of these 6 specimens retained fragments of E6/E7, LCR/E7 and early sequence of E1 fragment (sequence: 1188–1373) but deleted most part of E1.     

Human papillomavirus, cytomegalovirus and herpes simplex virus infections for cervical cancer in Taiwan

Previously, we had reviewed 43 cases of invasive cancers, adenosquamous cell carcinoma and adenocarcinoma for HPV type infections. With the same cases we extended the investigation to cytomegalovirus (CMV) and herpes simplex virus (HSV) infections. Results show that the prevalence of CMV and HSV infections from these cases of cervical carcinoma was 67 and 76%, respectively, by polymerase chain reaction. The results of the analysis of the association of HPV, CMV and HSV with various clinical characteristics of cervical cancer patients indicated that the correlation between HSV infections and clinical stages of squamous carcinoma was marginally significant (P=0.068). HSV infections seemed to have a higher association with cell keratinization pattern as compared with the other two viral infections.     

The prediction of late rectal complications in patients treated with high dose-rate brachytherapy for carcinoma of the cervix

: The aim of this work is to invetigate an unusually high rate of late rectal complications in a group of 43 patients treated with concomitant irradiation and chemotherapy for carcinoma of the cervix between December 1988 and April 1991, with a view to identifying predictive factors.

: The biologically effective dose received by each patient to the rectal reference point defined by the International Commission of Radiation Units and Measurements, Report 38, were calculated. Radiotherapy consisted of 46 Gy external beam irradiation plus three dose-rate intracavitary treatments of 10 Gy each prescribed to point A. Cisplatin 30 mg/m² was given weekly throughout the duration of the irradiation. The results have been compared to data from 119 patients treated with irradiation alone to assess the cofounding effect of the cisplatin.

: The relationship between the biologically effective dose delivered to the rectal reference point and the development of late complications shows a strong dose-response with a threshold for complications occurring at aproximately the same biologically effective dose threshold as that found for external beam irradiation in the head and neck region. The date from the group of patients treated wihout cisplatin is comparable to the date from the first group of patients in the lower dose ranges; the higher doses were not used and thus are not available for comparison.

: Using the linear quadratic model applied to our clinical results, we have established a threshold for late rectal complications for patients treated with external beam irradiation and high dose-rate brachytherapy for carcinoma of the cervix. This threshold is consistent with similar data for external irradiation in the head and neck region.     

Expression of c-erbB-2 and PCNA in cervical adenocarcinoma and its signification

Objective: To investigate the significance of c-erbB-2 and PCNA expression in adenocarcinoma. Methods: Expression of c-erbB-2 and PCNA in 74 cases of adenocarcinoma of the uterine cervix was examined by immunohistochemistry. Results: The expression of c-erbB-2 was detected in 34 cases. The positive staining of c-erbB-2 was associated with increased lymph node metastasis (57.1% Vs 24.0%, P=0.041) and lower 5-year survival rate (32.4% Vs 58.9%, P=0.008). The average PCNA labeling index (PCNA LI) was 40.6% (0.1%–91.4%). High PCNA LI was associated with lymph node metastasis (56.4% Vs 38.5%, P=0.016) and lower 5-year survival rate (28.7% Vs 64.4%, P=0.005). Positive staining of c-erbB-2 were associated with high PCNA LI (44.7% Vs 34.6% P=0.003). Conclusions: c-erbB-2 and PCNA LI were associated with malignant biological behavior and poor prognosis of patients with cervical adenocarcinoma.     

Ⅱb期宫颈癌不同治疗方法效果的比较

 180例Ⅱb期宫颈癌患者接受了不同治疗方法,比较其五年生存率。结果显示:单纯体外放疗组30.0％;术后放疗组62.5％;体外加腔内根治剂量放疗且80.1％;术前放疗组88.0％。术前放疗组与单纯体外放疗组及术后放疗组比较,(P<0.01),与体外加腔内根治剂量放疗组比较,(P>0.05)。结论:单纯体外放疗不宜作为宫颈癌治疗常规方法,术前体外加腔内放疗可能有助于生存率提高。