Sexual activity,health and well-being – the beneficial roles of coitus and masturbation

Abstract

The beneficial and well-being effects of human sexual arousal induced by coitus or masturbation are reviewed. Greater sexual satisfaction and some health rewards are given by coitally obtained orgasms even though those from masturbation may be more physiologically intense. The functionality of the circulatory, neural and muscular systems of the male and female genitalia are maintained by arousal and orgasm (maintenance functions) both in the conscious state and when asleep. Prophylactic actions (preventative functions) occur in relation to prostate cancer, implantation and dysmenorrhoea. In the male, ejaculations keep sperm morphology and semen volume within normal ranges while leukocyte numbers are increased. In the female, with coital vaginal deposition of semen mood enhancement occurs, menstrual cycles are more often of the ovulatory (fertile) type and postmenopausal vaginal atrophy is counteracted.     

子宫次全切后行残留子宫颈切除术27例临床分析

目的 回顾性分析27例子宫次全切后行残留子宫颈切除术患者的临床资料,探讨子宫次全切后行残留子宫颈切除术的临床策略.方法 回顾性分析我科2012-2014年收治的27例残留子宫颈切除患者的临床资料.患者均在院外行子宫次全切除术,并于我院接受残留子宫颈切除术.其中,开腹手术2例,腹腔镜中转开腹的1例,腹腔镜手术的24例.结果 患者行次全子宫切除术时年龄为29 ～52(44.2 ±6.7)岁.2例因产后出血行子宫次全切除,25例因患者要求保留子宫颈行子宫次全切除.残留子宫颈切除时间距子宫次全切除术时间平均53(0.5 ～251.0)个月,包括宫颈残端肌瘤8例,宫颈残端癌19例.术后共发生4例并发症,包括肠瘘1例,肠梗阻1例,腹壁脓肿合并肺炎1例,膀胱阴道瘘1例.与同时期我院收治并行子宫全切的482例患者比较,残留子宫切除术患者手术时间更长,术中出血量更多,住院天数更久,住院费用更高,且差异有统计学意义(P ＜0.05,P＜0.01).结论 行残留子宫颈切除应根据个人的手术习惯和对各种路入途径的掌握情况而定,但要由有经验的医师主刀.若患者坚决要求行次全子宫切除,术前应排除宫颈和内膜恶性病变,术后要求严密随访宫颈.     

血清鳞状细胞癌抗原、组织蛋白酶D和糖类抗原125检测对宫颈鳞癌诊断及预测转移的应用价值

目的  探讨血清鳞状细胞癌抗原（SCCAg）、组织蛋白酶D（Cath-D）、糖类抗原125（CA125）联合检测对宫颈鳞癌诊断及预测转移的临床应用价值。方法  酶联免疫吸附法（ELISA）检测血清中SCCAg和Cath- D水平,全自动化学发光免疫分析法检测CA125。收集2009年1月30日-2012年4月1日宫颈鳞癌患者（ⅠA2～ⅡA期）60例为研究组;宫颈上皮内瘤变组（CIN组）60例为对照组1;慢性宫颈炎组60例为对照组2。研究组在术前检测血清SCCAg、Cath-D、CA125水平,分析血清SCCAg、Cath-D、CA125水平与宫颈鳞癌、临床病理特征、转移及复发之间的相关性。结果  宫颈鳞癌组手术前的SCCAg、Cath-D和CA125水平分别为（1.41±0.26）ng/ml、（19.14±1.52）ng/L和（17.42±0.90）u/ml,明显高于CIN组和慢性宫颈炎组,差异有统计学意义（P = 0.003、0.005、0.000、0.000、0.000和0.000）;SCCAg、Cath-D水平与宫颈鳞癌临床分期、肿瘤体积、分化程度、间质浸润深度、脉管癌栓、宫旁转移、盆腔淋巴结转移有不同程度相关,差异有统计学意义（P <0.05）,CA125水平变化与宫颈癌间质浸润深度密切相关,差异有统计学意义（P =0.007）。应用工作特征曲线（ROC）分析SCCAg、Cath-D和CA125诊断宫颈鳞癌的临界值分别为1.03 ng/ml、13.58 ng/L和8.16 u/ml,预测转移临界值分别为3.21 ng/ml、21.20 ng/L和12.45 u/ml,曲线下面积（AUC）分别为0.954、0.905和0.718。结论  血清SCCAg和Cath-D水平对宫颈鳞癌的诊断、临床分期、预判复发具有很高的临床诊断价值;SCCAg、Cath-D和CA125 3项指标联合使用,可明显提高预测宫颈鳞癌转移的临床价值。

     

Abnormal fragile histidine triad (Fhit) expression in invasive cervical adenocarcinoma: association with tumor aggressiveness

The fragile histidine triad (FHIT) gene is a candidate tumor suppressor gene. Aberrant expression of the encoded protein and inactivation of FHIT correlate with several clinicopathological parameters in various tumor types, including cervical cancer, but Fhit expression has rarely been studied in cervical adenocarcinoma. We assessed Fhit protein expression in 35 surgical specimens of invasive adenocarcinomas of the uterine cervix and investigated whether expression alteration on immunohistochemistry staining is associated with important clinicopathological features. Considerably reduced or absent Fhit staining was observed in 11 cancers (31.4%). By univariate analysis, Fhit protein expression was significantly associated with nodal status (P = .002), histologic grade (P = .000), and International Federation of Gynecology and Obstetrics stage (P = .032). Depth of invasion, tumor size, or parametrial invasion did not show important association with Fhit. Lymph node status, International Federation of Gynecology and Obstetrics stage, and histologic grade are known prognostic factors of cervical adenocarcinoma, and Fhit status on immunohistochemistry staining demonstrated significant association with tumor aggressiveness. Staining of biopsy specimens for Fhit is worthy of study as a prognostic tool.     

宫颈“低离正”性腺癌临床病理分析

目的：探讨宫颈“低离正”性腺癌（minimal deviation adenocarcinoma，MDA）的临床病理学特征。方法：对10例宫颈“低离正”性腺癌进行临床病理分析。结果：10例临床表现均有大量白带增多。腺体显著增多，浸润性生长，CEA表达阳性。结论：子宫颈“低离正”性腺癌，以其特殊的形态结构和细胞轻微的异型为特征，当临床有白带大量增多，宫颈增粗变硬时应警惕MDA的可能。     

宫颈癌患者手术后尿潴留的综合防护

笔者对1999年3月~2003年10月收治的49例宫颈癌行次广泛子宫切除术和广泛全子宫切除加盆腔淋巴结清扫术患者的临床护理进行回顾性的分析。认为术前心理疏导,术后采取综合防护:膀胱冲洗,1∶5000高锰酸钾溶液坐浴,耻骨上膀胱造瘘等,能有效减少尿潴留的发生。     

PCNA和MMP9在宫颈癌组织中的表达与意义

目的: 探讨PCNA,MMP9在宫颈癌组织中的表达及临床意义. 方法: 用免疫组织化学SP法检测46例宫颈癌及10例正常宫颈中PCNA和MMP9的表达,分析不同组织中PCNA和MMP9表达的差异及两者的相关性. 结果: 宫颈癌组织PCNA的表达明显高于正常宫颈组织(P=0.000);38例宫颈癌的MMP9阳性表达(82.61%)明显高于10例正常宫颈组织的表达(30%, P﹤0.05);PCNA的表达与MMP9的表达呈正相关(rs=0.433, P=0.003),且PCNA和MMP9均与临床分期有关(P﹤0.05),而与年龄、病例分级及生长方式无关(P﹥0.05). 结论: MMP9在宫颈癌组织中表达异常增高,与细胞增殖关系密切,提示其对宫颈癌的发展起重要作用.     

Genomic characterization of small cell carcinomas of the uterine cervix

Small cell carcinoma (SCC) of the uterine cervix is a rare and aggressive form of neuroendocrine carcinoma, which resembles small cell lung cancer (SCLC) in its histology and poor survival rate. Here, we sought to define the genetic underpinning of SCCs of the uterine cervix and compare their mutational profiles with those of human papillomavirus (HPV)‐positive head and neck squamous cell carcinomas, HPV‐positive cervical carcinomas, and SCLCs using publicly available data. Using a combination of whole‐exome and targeted massively parallel sequencing, we found that the nine uterine cervix SCCs, which were HPV18‐positive (n = 8) or HPV16‐positive (n = 1), harbored a low mutation burden, few copy number alterations, and other than TP53 in two cases no recurrently mutated genes. The majority of mutations were likely passenger missense mutations, and only few affected previously described cancer‐related genes. Using RNA‐sequencing, we identified putative viral integration sites on 18q12.3 and on 8p22 in two SCCs of the uterine cervix. The overall nonsilent mutation rate of uterine cervix SCCs was significantly lower than that of SCLCs, HPV‐driven cervical adeno‐ and squamous cell carcinomas, or HPV‐positive head and neck squamous cell carcinomas. Unlike SCLCs, which are reported to harbor almost universal TP53 and RB1 mutations and a dominant tobacco smoke‐related signature 4, uterine cervix SCCs rarely harbored mutations affecting these genes (2/9, 22% TP53; 0% RB1) and displayed a dominant aging (67%) or APOBEC mutational signature (17%), akin to HPV‐driven cancers, including cervical adeno‐ and squamous cell carcinomas and head and neck squamous cell carcinomas. Taken together, in contrast to SCLCs, which are characterized by highly recurrent TP53 and RB1 alterations, uterine cervix SCCs were positive for HPV leading to inactivation of the suppressors p53 and RB, suggesting that these SCCs are convergent phenotypes.     

阴道镜在癌前病变及早期宫颈癌筛查中的应用价值

目的评价阴道镜在癌前病变及早期宫颈癌筛查中的应用价值。方法对521例妇科门诊宫颈癌高危人群进行阴道镜检查,并在阴道镜下定点活检,与组织病理学对照。结果521例患者中共检查出异常70例,经病理确诊宫颈癌前病变52例,宫颈癌7例,诊断假阴性率为0;诊断敏感度为100%,特异度为97·45%。结论阴道镜在癌前病变及早期宫颈癌筛查中具有重要的应用价值。