应用B超与子宫内膜病理检查联合诊断异常子宫出血232例分析

目的探索子宫异常出血症的B超声象与子宫内膜病理检查的关系.方法对232例子宫异常出血患者采用B超检查后做子宫内膜活组织病理检查,对B超显示子宫内膜增厚≥5mm或者有异常回声者作观察组,B超正常者为对照组.结果观察组190例中病理检查显示正常子宫内膜21例(11.05%),异常子宫内膜169例(88.95%),其中不全流产33例、子宫内膜炎12例、子宫内膜增生过长及分泌不良98例、子宫内膜息肉及粘膜下肌瘤15例、子宫内膜恶性病变11例;对照组42例中有4例(9.53%)为不全流产外,其余无病理征.结论先采用B超探查子宫内膜,对有异常声象作诊括术进行病理检查是诊断子宫异常出血症较为方便、简捷、有效的方法.     

子宫腺瘤样瘤临床病理分析

目的 探讨子宫腺瘤样瘤的组织发生、临床病理特征及鉴别诊断。方法 对ll例子宫腺瘤样瘤的资料，进行综合分析，光镜观察。其中6例进行免疫组化标记。结果 年龄2l—58岁，临床表现无特征性，肿瘤好发子宫角、宫底处。光镜下表现为上皮样细胞形成腺样、腔隙、条索样结构，有些上皮样细胞可呈空泡状、印戒样。大多伴有平滑肌瘤或平滑肌增生。免疫组化：CK、EMA、VIM、Calretinin均阳性表达，而FⅦ因子相关抗原、CEA均阴性。结论 子宫腺瘤样瘤是一种良性病变，符合间皮来源，尤其注意的是：此瘤出现以空泡、印戒样细胞为主时，易误诊为腺癌或印戒细胞癌，结合免疫标记，可鉴别之。     

ET—1、ETA—R、c—fos原癌原因mRNA在子宫肌瘤中的表达

目的 :探讨ET 1及ETA R表达在子宫肌瘤发生中的病理生理作用及其与肌瘤中c fos原癌基因之间的关系。方法 :应用半定量RT PCR方法检测 30例子宫肌瘤组织及邻近正常子宫肌组织中ET 1、ETA R、c fosmRNA的表达强度 ,对照其差异。结果 :( 1)子宫肌瘤组织中ET 1mRNA的表达强度 ( 2 .717± 0 .5 2 0 )与正常子宫肌组织 ( 2 .4 83± 0 .62 3)差异有显著性 (P <0 .0 5 ) ;ETA RmRNA在子宫肌瘤组织中表达为 2 .2 17± 0 .4 68,明显高于正常子宫肌组织的 1.617± 0 .4 86(P <0 .0 0 1) ;c fosmRNA在子宫肌瘤组织中表达为 4 .90 0± 0 .4 0 3,也明显高于正常子宫肌组织的 4 .183± 0 .5 94 ,(P <0 .0 0 1) ;( 2 )相关分析表明 :肌瘤组织中ETA RmRNA与c fosmRNA之间呈正相关 ,而ET 1mRNA与ETA RmRNA、c fosmRNA之间无相关性。结论 :子宫肌瘤组织中ETA R的表达上调对子宫肌瘤细胞的分裂增殖起促进作用 ,ET 1/ETA R系统可能是子宫肌瘤发生发展的机理之一     

子宫肌瘤与孕激素及细胞凋亡的相关研究

目的　通过检测孕激素受体 (PR)、增殖细胞核抗原 (PCNA)、凋亡抑制基因Bcl- 2蛋白在子宫肌瘤组织中的表达 ,探讨子宫肌瘤的发生与孕激素及细胞凋亡的关系。方法　应用免疫组化SP法检测 30例子宫肌瘤及其邻近肌层组织中PR、PCNA、Bcl - 2的表达。结果　PR、PCNA、Bcl- 2在子宫肌瘤细胞中的表达明显高于其邻近肌层 (P <0 0 5 ,P <0 0 5 ,P <0 0 0 1)。PR的表达与PCNA、Bcl- 2的表达均呈正相关。结论　子宫肌瘤是卵巢性激素依赖性肿瘤。孕激素是促进子宫肌瘤生长的重要因素 ,子宫肌瘤与细胞凋亡有关     

宫血净口服液治疗崩漏的止血机理研究

目的:探讨宫血净口服液治疗崩漏的止血机理.方法:通过宫血净口服液与血康口服液对气虚血淤动物模型作用的相关指标的测定,采用单因素方差分析的统计学方法来分析宫血净口服液治疗崩漏的止血机理.结果:宫血净口服液能降低大鼠全血粘度比、血浆粘度、全血低切还原粘度、全血低切相对粘度,宫血净大剂量组与模型组对照,全血低切相对粘度、全血低切还原粘度数数值有极显著差异(P＜0.01),全血粘度比(高低切)、血浆粘度有显著性差异(P＜0.05);其中全血粘度比(低切)与血康组比较有显著性差异(P＜0.05);宫血净小剂量组与模型组对照全血低切相对粘度、全血低切还原粘度值有极显著性差异(P＜0.01),全血粘度比(高、低切)、血浆粘度有显著性差异(P＜0.05),与血康组比较,全血粘度比(高、低切)有显著性差异(P＜0.05);明显延长BT、CT,以小剂量组明显(P＜0.01);宫血净口服液大剂量组使E2上升,与模型组E2对照,有显著性差异(P＜0.05);宫血净口服液小剂量组有增强大鼠子宫收缩力的作用,使子宫平滑肌收缩幅度提高,活动力增强;阳性对照组有抑制子宫收缩幅度及收缩活动力的作用.结论;宫血净口服液治疗崩漏的止血机理上是一综合作用.     

固肾止漏胶囊治疗功能性子宫出血临床研究

目的　观察固肾止漏胶囊治疗功能性子宫出血的临床疗效。方法　将 2 3 4例患者按年龄层次随机分为 2组 ,治疗组 1 5 6例用固肾止漏胶囊 ,对照组 78例用三七片。2组均每月连服 1 0日 ,3个月为 1个疗程 ,治疗 1个疗程观察疗效。结果　对照组治愈率 2 6.92 % ,总有效率 82 .0 5 % ;治疗组治愈率 83 .97% ,总有效率 97.44%。 2组治愈率、总有效率比较均有显著性差异 (P <0 .0 1 ) ,治疗组疗效明显优于对照组。结论　固肾止漏胶囊治疗功能性子宫出血具有良好疗效。     

子宫动脉栓塞治疗子宫肌瘤的临床研究

目的 :评价选择性子宫动脉平阳霉素碘油乳剂 (PLE)灌注及栓塞 ,治疗子宫肌瘤的临床疗效及安全性。方法 :对30例子宫肌瘤患者行选择性子宫动脉PLE灌注及明胶海绵颗粒栓塞 ,随访3～18个月 ,观察子宫及肌瘤缩小的程度及临床症状缓解情况。结果 :栓塞技术成功率100 % ,子宫动脉造影显示肌瘤外层血管增粗纡曲 ,分支数量增多 ;肌瘤内部见致密的毛细血管网。30例栓塞后6个月 ,临床症状明显改善 ,肌瘤体积平均缩小约48 % ,总有效率达100 %。结论 :PLE选择性子宫动脉栓塞治疗是一种安全可靠创伤小 ,疗效高的好方法。     

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.     

Case reports: Giant malignant fibrous histiocytoma of the uterus

A case of giant (32 Kg) malignant fibrous histiocytoma (MFH) arising from the uterus and occupying the entire abdomen and the pelvis is reported. The patient had debulking surgery, followed by combination chemotherapy, but died 7 months after diagnosis.     

Uterine myomas and factors associated with hysterectomy in premenopausal women

OBJECTIVE: Our purpose was to describe clinical characteristics in premenopausal women with uterine myomas and to identify factors associated with hysterectomy.STUDY DESIGN: Data were collected by chart abstraction in 421 premenopausal women with myomas and analyzed by univariate and multivariable regression.RESULTS: Over a median follow-up period of 29 months, 86% of women had symptoms associated with myomas and 40% had an increase in uterine size of >2 gestational weeks. By multivariable regression, bleeding symptoms at presentation and previous surgical history of cholecystectomy and adhesiolysis were significantly associated with greater odds of hysterectomy. There was a significant interaction between age and uterine size, so that as age increased, uterine size had a greater impact on the likelihood of hysterectomy.CONCLUSIONS: In this cohort of premenopausal women myomas were associated with symptoms in almost all women over the follow-up period. Hysterectomy was performed in 22% of women overall. (Am J Obstet Gynecol 1997;176:1213-9.)