输卵管的微环境研究

输卵管微环境含有特异性蛋白质、细胞因子、黏附因子、酶等多种物质。特异性蛋白质包括OGP和输卵管素。OGP可提高精子的存活率和活力,参与精子的获能和顶体反应,也可作为诊断子宫内膜病变的标志物。同源的输卵管素可增强精子与透明带的结合,而异源的则相反起抑制作用。细胞因子包括LIF、gp130、TNF-α、IL-6。LIF与gp130两者在胚胎的植入、蜕膜化、胎盘的形成和胎儿的发育中扮演着重要的角色。TNF-α与IL-6在防止病原体集居的同时,也促进了炎症反应,造成了输卵管局部组织损伤。黏附因子介导细胞间的黏附和信号转导,影响细胞的增殖、分化、迁移和死亡。输卵管微环境物质可作为输卵管相关疾病或病变程度检测的标志物,可作为介入治疗药物的选取及分量参考依据,有望应用于临床疾病治疗。     

抗白色假丝酵母菌IgY的应用研究

目的探讨抗白色假丝酵母菌IgY对小鼠阴道白色假丝酵母菌感染的治疗作用,及抗白色假丝酵母菌IgY泡腾片的安全性和对外阴阴道假丝酵母菌病的治疗效果。方法2001年5月至2003年5月于南昌大学医学院免疫学教研室应用抗白色假丝酵母菌IgY对小鼠阴道白色假丝酵母菌感染进行保护性研究;观察抗白色假丝酵母菌IgY泡腾片对新西兰兔的急性皮肤刺激试验、阴道局部黏膜刺激试验的结果及对外阴阴道假丝酵母菌病患者的临床效果。结果(1)小鼠阴道冲洗液白色假丝酵母菌培养结果(菌落数)抗白色假丝酵母菌IgY中剂量组与制霉菌素阳性对照组之间差异无显著性意义(0.3947±0.3265对0.3336±0.4634)。(2)新西兰兔试验部位皮肤、阴道黏膜及周围皮肤无红斑、水肿等,全身情况未见异常;阴道黏膜亦未见病理改变。(3)抗白色假丝酵母菌IgY泡腾片对外阴阴道假丝酵母菌病有效率88.9%,与硝酸咪康唑栓对照组(82.5%)比较差异无显著性意义。结论抗白色假丝酵母菌IgY对小鼠阴道白色假丝酵母菌感染有明显的保护作用;抗白色假丝酵母菌IgY泡腾片对皮肤、阴道黏膜无刺激作用;对外阴阴道假丝酵母菌病有很好的治疗效果。     

巨大胎儿预测方法探讨

目的 探讨巨大胎儿的预测方法。方法 测量408例足月孕妇的宫高,计算以不同的宫高作为截断值筛选巨大胎儿的灵敏度、特异度,选取最优截断值。宫高≥最优截断值者176例,行B超检查,测量胎儿腹围(AC)、小脑横径(CD)、双顶径(BPD),并与新生儿出生体重进行相关分析,经二元线性回归推导出以AC、CD预测胎儿体重(FW)的方程式。应用560例进行临床验证。结果 宫高37cm为筛选巨大胎儿的最优截断值,其灵敏度、特异度分别为88.9％、66.7％。宫高≥37cm者,AC与出生体重的相关性最好,CD次之,偏相关系数分别为0.684 54(P<0.001)、0.221 52(P<0.05);以AC、CD预测(FW=269.6×AC 438.4×CD-7642.8).r=0.67(P<0.001)。经560例临床验证,预测巨大胎儿的灵敏度、特异度分别为83.3％、92.2％。预测体重与实际体重的符合率为82.7％。结论 以宫高初步筛选、再以B超测量胎儿AC、CD预测巨大胎儿,方法简便,且较准确,具有临床使用价值。     

剖宫产术后的安全性研究

目的 比较剖宫产与自然分娩者产后两年内并发症的异常情况的发生情况,以评估剖宫产术后安全性,方法 采用历史前瞻性流行病学方法。结果 剖宫产后两年内切口痛,子宫活动度受限,慢性腹痛发生率分别为５．１％、９．６％、４．３％,贫血发生率为１１．１％,均高于自然分娩者,差异有统计学意义,结论 为了保护妇女的身心健康,必须正确掌握剖宫产指征。     

Study on the histopathological abnormalities of the umbilical cord

There have been very few reports of studies on histological abnormalities of the umbilical cord. In the present study, we have investigated various abnormalities of the cord with special emphasis on the cord vasculature and the vestigial remnants based on developmental abberations. The incidence of single umbilical artery was 1/509 (0.2%), by which no special relation was signified between the single artery and the occurrence of congenital malformations of the neonate. Supernumerary umbilical vessels were found in 5/509 (1.0%) of the cases examined. Three out of five revealed the umbilical cord with two arteries and two veins, while two of them showed the umbilical cord with the normal 3 vessels associated with an accessory fourth vessel. It is of a great interest to note that fetal distress with or without fetal acidosis was demonstrated in all cases with the accessory fourth vessel, whereas the presence of supernumrary umbilical vessels was least related to the occurrence of congenital malformations of the neonates. The incidence of vestigial remnants was 30/509 (5.9%). The vestigial remnants were classified into two groups according to their epithelial pattern, i.e. flat epithelium and cuboidal or columnar epithelium. The vestigial remnants with flat epithelium type, considered to originate in the allantoic duct, were found in 2/3 (66.7%) of all cases with vestigial remnants. The vestigial remnants with cuboidal or columnar epithelium, considered to originate in the omphalomesenteric duct, were found in 1/3 (33.3%) of all cases with vestigial remnants, one of which case was associated with congenital malformation of omphalocele of the neonate.