原发性女性生殖器恶性黑色素瘤16例分析

目的：探讨原发性女性生殖器恶性黑色素瘤的临床病理特点及合理的治疗方法。方法：对16例原发性女性生殖器恶性黑色素瘤的临床资料进行回顾性分析。结果：发生于外阴9例,阴道5例,子宫颈2例。全部病例均行手术加化疗综合治疗,行区域淋巴结清扫11例,4例有转移,转移率36.3％。存活＜2年8例,≥2年8例,其中≥5年仅2例。结论：原发性女性生殖器恶性黑色素瘤预后差,行根治手术辅化疗和免疫治疗,可望提高生存期。     

The pattern of gynecological malignancies in Al-Madinah Al-Munawarah region,Saudi Arabia: An overview of 6 years

Objectives:To describe the frequency and spectrum of different types of gynecological malignancies (malignant tumors of the female genital tract) and to characterize the pattern of gynecological neoplasms in different age groups in Al-Madinah Al-Munawarah, Saudi Arabia.Methods:This 6-year retrospective-design research was carried out on different age groups in Al-Madinah Al-Munawarah region, from June 2015 until June 2021. The patients’ information of all 200 specimens, including age, nationality, tumor site, and pathological disorders was obtained from the Maternity and Children Hospital, Al-Madinah Al-Munawarah.Results:Endometrial cancer was the most common malignancy for women of 31 years and above (69.0%). Tumors of the uterine corpus were mostly epithelial (86.7%) and possessed an endometrioid carcinoma histology (90.6%). There was only a small decline in gynecological cancer incidences in Al-Madinah Al-Munawarah over the past 6 years.Conclusion:Most of the cancer incidences, regardless of the pathological diagnosis, either increased or remained unchanged over time, is a possible indication of the current state of health programs and information available to the citizens in Al-Madinah Al-Munawarah. Further studies exploring the economic background of diagnosed patients may be of interest to future research.     

Laparoscopic findings in female genital tuberculosis

OBJECTIVES: To evaluate the laparoscopic findings in genital tuberculosis (TB). METHODS: A total of 85 women of genital TB, who underwent diagnostic laparoscopy for infertility or chronic pelvic pain were enrolled in this retrospective study conducted in our unit at All India Institute of Medical Sciences, New Delhi, India from September 2004 to 2007. RESULTS: The mean age was 28.2 years and the mean parity was 0.24. Most women were from poor socioeconomic status (68.1%). Past history of TB was seen in 29 (34.1%) women with pulmonary TB in 19 (22.35%) women and extrpulmonary in 10 (11.7%) women. Most women presented with infertility (90.6% primary 72.9%; secondary 17.6%) while the rest had chronic pelvic pain (9.4%). The mean duration of infertility was 6.2 years. A total of 49 (57.6%) women had normal menses, while hypomenorrhea, oligomenorrhea, secondary amenorrhea and menorrhagia were seen in 25 (30.1%), 3 (3.5%), 5 (5.9%), and 2 (2.4%) women respectively. Diagnosis of genital TB was made by histopathological evidence of TB granuloma in 16 (18.8%) (Endometrial biopsy in 12.9%, laparoscopy biopsy in 5.9%) women, demonstration of acid fast bacilli (AFB) on microscopy in 2(2.3%), positive AFB culture in 2 (2.3%), positive polymerase chain reaction (PCR) in 55 (64.7%) and laparoscopic findings of genital TB in 40 (47.1%). The various findings on laparoscopy were tubercles on peritoneum (12.9%) or ovary (1.2%), tubovarian masses (7.1%), caseous nodules (5.8%), encysted ascitis in 7.1% women. Various grades of pelvic adhesions were seen in 56(65.8%) women. The various findings on fallopian tubes were normal looking tubes in (7.1%), inability to visualize in 12(14.1%), presence of tubercles on tubes in 3 (3.52%), caseous granuloma in 3 (3.52%), hydrosalpinx in 15 (17.6%) (Right tube 11.7%, left tube 5.9%), pyosalphinx in 3 (3.5%) on right tube and 2 (2.35%) in left tube, beaded tube in 3 (3.5%) on right tube, 4 (4.7%) in left tube with tobacco pouch appearance in 2 (2.35%) women. The right tube was patent in 9 (10.6%) while left tube was patent in 10(11.7%) cases only, while they were either not seen (absent in one case due to previous salphingectomy, inability to see due to adhesion in 14.12%) or blocked at various sites with cornual end being most common in 3 (3.5%) showing multiple block in right tube and 4.7% in left tube. CONCLUSION: There is a significant pelvic morbidity and tubal damage in genital tuberculosis.     

西藏地区女性生殖器结核76例临床治疗分析

目的:探讨西藏地区女性生殖器结核治疗情况及预后。方法:回顾性分析76例藏族妇女生殖器结核患者发病年龄、典型症状和采取治疗方法及结局。结果:一般+化学治疗61例,预后好25例;一般+化学+手术治疗16例,预后好11例。各年龄段生殖器结核典型表现不同。结论:女性生殖器结核主要采用抗结核化疗或手术治疗,应严格掌握手术指征。     

不孕症肝郁病理的生殖内分泌实质研究

目的 :探讨肝郁的病理实质及其与下丘脑—垂体—性腺系统功能紊乱———排卵障碍之间的相关性。方法 :选择原发性不孕症患者 70例 ,正常已产妇女 19例作对照 ,以肝郁病理积分、性激素检测为指标。结果 :1.不孕症患者肝郁积分及肝郁分级均显著高于对照组 (P <0 .0 1)。 2 .月经周期第 10天 ,肝郁 3级E2 较 0级、2级显著降低 (P <0 .0 5 ) ;肝郁分级与性激素间无相关性 ;而PRL与E2 、P、P/E2 呈负相关 (P <0 .0 5～P <0 .0 1) ;PRL与LH、LH/FSH呈正相关 (P <0 .0 5 )。 3.月经周期第2 0天 ,肝郁 1级、3级LH较 0级显著降低 (P <0 .0 1) ;肝郁 3级P较 0级、2级显著增高 ;肝郁 3级PRL较 0级、2级显著升高(P <0 .0 5 ) ;肝郁分级与PRL呈正相关 (P <0 .0 5 ) ,PRL与LH/FSH呈正相关 (P <0 .0 5 )。结论 :“肝为生殖之枢” ,肝郁是不孕症的重要病理环节 ,肝郁———下丘脑—垂体—性腺系统功能紊乱———排卵障碍之间可能存在轴性相关     

Enhanced Heterosexual Transmission Hypothesis for the Origin of Pandemic HIV-1

HIV-1 M originated from SIVcpz endemic in chimpanzees from southeast Cameroon or neighboring areas, and it started to spread in the early 20th century. Here we examine the factors that may have contributed to simian-to-human transmission, local transmission between humans, and export to a city. The region had intense ape hunting, social disruption, commercial sex work, STDs, and traffic to/from Kinshasa in the period 1899–1923. Injection treatments increased sharply around 1930; however, their frequency among local patients was far lower than among modern groups experiencing parenteral HIV-1 outbreaks. Recent molecular datings of HIV-1 M fit better the period of maximal resource exploitation and trade links than the period of high injection intensity. We conclude that although local parenteral outbreaks might have occurred, these are unlikely to have caused massive transmission. World War I led to additional, and hitherto unrecognized, risks of HIV-1 emergence. We propose an Enhanced Heterosexual Transmission Hypothesis for the origin of HIV-1 M, featuring at the time and place of its origin a coincidence of favorable co-factors (ape hunting, social disruption, STDs, and mobility) for both cross-species transmission and heterosexual spread. Our hypothesis does not exclude a role for parenteral transmission in the initial viral adaptation.     

Clinical outcome analysis of male and female genital burn injuries: a 15-year experience at a level-1 burn center

Objectives: The American Burn Association classifies a burn to the genitalia as a major injury. Isolated burns to the penis, scrotum or vulva are rare as a result of protection provided by the thighs and abdomen. Thus, burned genitalia represent an ominous sign of a more extensive total body surface area burn. Methods: A retrospective analysis of consecutive patients admitted to a Level‐1 Burn Unit with a burn involving the genitalia from January 1995 to December 2009 comprised the study population. Results: A total of 393 patients of 5878 patients (6.7%) admitted to the Burn Unit suffered a burn involving the genitalia, including 253 males (64.4%) and 140 females (35.6%). The median total body surface area was 12% (range 1–100%), the most common cause of genital burn was scald (n = 246, 62.9%) and median length of stay was 9 days (range 1–472 days). A total of 269 patients (68.4%) were discharged to home from the hospital, and in‐hospital mortality was 20.9%. Conclusions: The typical profile for those sustaining a genital burn include younger patients (≤30 years‐of‐age), sustaining a median total body surface area burn of 12% from a scald injury, with extensive genitalia involvement. Length of stay for genital burns is usually extended and, as a result of concomitant injuries, is associated with a 20% in‐hospital death rate.     

HSV-2糖蛋白D在昆虫-杆状病毒表达系统中的表达及免疫原性分析

目的：在昆虫细胞中表达2型单纯疱疹病毒（HSV-2）糖蛋白D（gD2）胞外区基因,检测其免疫原性。方法：以HSV-2病毒基因组为模板,PCR扩增得到gD2片段,构建至杆状病毒质粒Bacmind中,转染sf9细胞,包装重组杆状病毒,收集后连续感染sf9细胞,收获第4代重组杆状病毒（P4）,通过Western blotting法鉴定蛋白表达情况,采用空斑实验检测重组病毒滴度,将P4代重组病毒作为种子大量感染sf9细胞,上清经镍柱亲和层析进行纯化,将纯化后的蛋白在第0、2和4周免疫BALB/c小鼠（gD2组）,以PBS作为阴性对照（PBS组）,ELISA检测小鼠血清中gD2特异性IgG滴度。结果：PCR鉴定和DNA测序,重组表达质粒gD2-Bacmind构建正确,空斑实验检测重组病毒滴度为2.0×10⁹ pfu·mL^-1,纯化的gD2重组蛋白在相对分子质量37000处出现目标条带,纯度达90%以上。第6周gD2组小鼠免疫血清中gD2特异性IgG抗体滴度Log10平均值达到4.34,与PBS组比较差异有统计学意义（P<0.01）。结论：利用昆虫-杆状病毒表达系统表达的gD2胞外区蛋白具有良好的免疫原性,可作为HSV-2疫苗的候选。     

原发女性生殖道恶性黑色素瘤21例临床分析

目的探讨原发性女性生殖道恶性黑色素瘤的临床特点、治疗及预后。方法回顾分析本院1986年1月至2006年3月收治的原发性女性生殖道恶性黑色素瘤患者21例。其中外阴8例、阴道10例、阴道及宫颈1例、外阴及阴道1例、盆腔1例。结果患者中位年龄50(21~71)岁。临床表现主要为阴道流血、流液及发现外阴或阴道肿物。本资料阴道恶性黑色素瘤发病率高于外阴恶性黑色素瘤。按照国际妇产科联盟(FIGO)分期,期别和预后呈负相关。治疗以手术为主,手术方式由根治性切除逐渐衍变为扩大局部切除。随访:21例患者中随访率为67%(14/21),随访时间6~96个月,死亡7例,随访期间的死亡率为50%。结论女性生殖道恶性黑色素瘤发病率低,预后差。肿瘤厚度和淋巴结转移是其主要的危险因素。应采用手术基础上的综合治疗,治疗方案个体化。