大鼠宫颈MMP-2动态表达的研究

目的通过检测大鼠宫颈基质金属蛋白酶-2（matrix metalloproteinases2,MMP-2）的动态表达,探讨胶原降解与宫颈成熟的关系。方法清洁级大鼠,分为A组：未孕动情间期;B组：妊娠10d;C组：妊娠16d;D组：妊娠19d;E组：分娩后即刻组;每组各6只大鼠。苏木精-伊红（hemotoxylin and eosin stai-ning,HE）常规染色显示宫颈大体结构;免疫组织化学染色显示MMP-2。结果①HE染色显示大鼠宫颈主要由大量纤维（胶原纤维和肌纤维）组成,E组宫颈间质见少量中性粒细胞,其余各组未见中性粒细胞。②MMP-2（棕染）在所有组别间质均有表达,鳞状上皮无表达,胶原纤维、平滑肌纤维、上皮及少量血管壁呈阳性表达;妊娠19d和分娩后即刻组阳性表达的密度较其他组增强。结论宫颈成熟后,宫颈纤维组织松散、断裂,中性粒细胞由外源性血管浸润到宫颈间质,这一变化在分娩时尤其明显,MMP-2这一基质金属蛋白酶对宫颈纤维存在降解作用,导致宫颈软化、扩张。     

社区成人慢性咳嗽的诊疗方法探讨

目的探讨社区成人慢性咳嗽的诊疗方法和安全性。方法选取2009年1月～2013年1月东莞市厚街镇社区卫生服务中心收治的慢性咳嗽患者325例,随机分为2组。观察组进行实验室检查,对照组进行影像学检查的,分析检查结果的合理性。结果使用实验室检查的患者检出疾病原因率明显高于使用影像学检查患者疾病原因率,差异有统计学意义（P〈0.05）。结论实验室检查治疗中发挥着关键作用,检查全面、不良反应小,值得临床推广应用。     

大鼠宫颈MMP-2、MMP-8动态表达的研究

目的 通过检测大鼠宫颈基质金属蛋白2(MMP-2)、基质金属蛋白8(MMP-8)的动态表达,探讨胶原降解与宫颈成熟的关系.方法 清洁级大鼠分为未孕动情间期、妊娠10d、妊娠16d、妊娠19d和分娩后即刻组,每组各6只.宫颈称湿重.HE 常规染色显示宫颈大体结构,VG染色进行胶原纤维和肌纤维显色,免疫组织化学染色显示MMP-2、MMP-8.结果 (1)HE染色显示大鼠宫颈主要由大量纤维(胶原纤维和肌纤维)组成,分娩后即刻组宫颈间质见少量中性粒细胞.其余组未见中性粒细胞.(2)临产前宫颈湿重已有增加,至分娩后即刻增加更明显.(3)宫颈纤维组织由胶原纤维和平滑肌纤维组成,所占比例无明显差别.分娩后即刻组胶原纤维和肌纤维排列较非分娩时松散.(4)MMP-2(棕染)在所有组别间质均有表达,鳞状上皮无表达,胶原纤维、平滑肌纤维、上皮及少量血管壁呈阳性表达;妊娠19d和分娩后即刻组阳性表达的密度较其他组增强.(5)分娩后即刻组MMP-8染色见间质散在中性粒细胞棕染.其他组的组织或细胞均未见阳性表达.结论 宫颈成熟后,官颈纤维组织松散、断裂,中性粒细胞由外源性血管浸润到宫颈间质,这一变化在分娩时尤其明显;MMP-2、MMP-8这两种不同来源的基质金属蛋白酶共同降解了宫颈纤维,导致宫颈软化、扩张.

Abstract：

Objective To elucidate the relationship between collagen degradation and cervical ripening by detecting dynamic expressions of matrix metalloproteinases 2 (MMP-2) and 8 (MMP-8) in rat cervix. Method SPF rats were divided into 5 groups (n=6), namely non-pregnancy estrus interval group, gestational days 10, 16, and 19 groups, and immediately postpartum group. The wet weight of the cervix was measured and HE staining was used to display the general structure of the cervix. VG staining was applied to visualize the collagen fibers and muscular fibers. Immunohistochemistry was performed to observe the expressions of MMP-2 and MMP-8 in the cervix. Results HE staining showed that the rat uterine cervix consisted mainly of ?broblasts and ?brous connective tissues. A small quantity of neutrophils could be seen in the cervix stroma of the rats immediately after immediately parturition, but not at the other time points. The wet weight of the antepartum cervix had increased, and a more obvious increase was seen in the wet weight of the cervix immediately after parturition. The collagen fibers of the cervix consisted of collagen fibers and smooth muscle fibers, and their proportions showed no significant variation at the time points around the parturition. Immediately after parturition, the collagen fibers and muscular fibers in the cervix became loosened as compared with that before parturition. MMP-2 expression was found in the cervical stroma but not in the squamous epithelium in nonpregnancy, term pregnancy, and immediately after parturition; the smooth muscle cells, vascular wall, and stromal ?broblasts showed positive expression of MMP-2. Enhanced intensity of MMP-2 staining was seen in term pregnancy and postpartum group in comparison with that in the other groups. MMP-8 expression was observed in the cervix of rats immediately after parturition, with scattered neutrophils positive for MMP-8 spotted in the stroma of the ripened cervix. MMP-8 expression was not detected in the other groups. Conclusion Ripened cervical fibrous tissue becomes loose and broken, and cervical ripening is accompanied by infiltration of neutrophils from exogenous vessels. These changes are particularly evident after parturition. MMP-2 and MMP-8 cooperate to degrade the cervical fibers, leading to cervical softening and expansion.     

早产病因学研究进展

早产是指自末次月经第一日开始计算数，妊娠在孕28-37周之间终止者。早产仍然是围产期新生儿发病及死亡的最主要原因，发生率占整个妊娠的10％，全世界大约70％新生儿死亡的原因为早产。     

910例早产原因与围产儿结局分析

目的探讨早产发生的主要原因和早产对围产儿结局的影响。方法对2000年1月～2008年12月住院分娩的910例早产病例资料进行回顾性研究。结果早产发生率22％;早产原因依次排位为：胎膜早破、自发性早产、胎盘因素、多胎妊娠、胎位不正、妊娠期高血压疾病、妊娠合并症、羊水因素、脐带因素、胎儿宫内窘迫、子宫畸形、宫颈机能不全、子宫脱垂。孕龄〉34W以上的早产儿发生新生儿窒息、呼吸窘迫综合症（Respiratory distress syndrome,RDS）、新生儿死亡的几率明显低于孕龄≤34W的早产儿。结论早产与妊娠并发症和妊娠合并症等密切相关,围产儿结局与胎龄和体重呈正相关。