宫内节育器的输卵管效应研究

给25只成年雌兔子宫内放置三种不同类型宫内节育器(IUD),6个月后,在检查IUD位置固定良好并有抗生育作用的基础上观察输卵管形态、分泌活动、肌肉活动及组织内Cu~(++)、PGs含量等变化。本文观察到兔子宫内放置金属单环、VCu200IUD及消炎痛VCu200IUD后输卵管组织内Cu~(++)含量均未明显增加;PGE/F比值呈上升趋势;峡部平滑肌收缩频率明显增加(P<0.05或0.01),未观察到紧张性阵发收缩波,粘膜皱襞完好,固有膜及乳头间质内可见不同程度充血、水肿及炎细胞浸润,上皮细胞内PAS阳性物质减弱,而分泌液葡萄糖含量无明显增减,结果表明兔子宫内放置惰性和活性IUD均能影响输卵管粘膜形态而输卵管肌肉活动及组织内Cu~(++)含量及分泌液中葡萄糖浓度则未发生明显变化。     

山羊输卵管放置镍钛记忆合金硅橡胶可复性避孕栓组织结构观察

目的观察镍钛记忆合金硅橡胶避孕栓的毒性反应、组织学改变。方法镍钛记忆合金和硅橡胶制成输卵管避孕栓。18只山羊在常规消毒下提出右侧子宫及输卵管,在近宫角2cm处切开1·5cm纵切口,行右侧输卵管栓堵,将输卵管栓放入输卵管,左侧为自身对照。术后1周、2周、1、3、6、12个月各随访1次,每次有3只山羊将双侧输卵管及实验侧的输卵管栓子同时取出送病理,观察毒性反应及组织学变化。结果山羊放置输卵管栓子术后1周、2周、1、3、6、12个月肉眼观察均无异常。组织学检查,术后1周输卵管内见有少量炎性细胞渗出、管腔变窄、但管壁无明显变化,也无周围组织粘连。术后半月~6个月,黏膜正常,黏膜下肌层无增生及萎缩,无炎性细胞浸润,浆膜无明显病理异常。术后12个月,输卵管内膜腺体和纤维细胞轻度增生,但浆膜无明显改变。结论镍钛记忆合金硅橡胶可复性输卵管栓放置后组织相容性好,无明显组织学改变及毒副反应。     

记忆合金药铜IUD对兔子宫内膜及重要脏器的组织形态学影响

目的:研究记忆合金药铜节育器(IUD)对兔子宫内膜及重要脏器的组织形态学影响。方法:将雌性日本大耳白兔随机分为3组,放置记忆合金药铜IUD(实验组)和放置不锈钢药铜IUD(对照组)各18只,空白对照组6只,手术放置IUD于兔子宫腔内,术后1、3、6个月处死兔,取出子宫、输卵管、卵巢和心肺肝脾肾组织,切片HE染色,光镜下进行组织学检查。结果:两置器组IUD直接压迫下的区域,子宫腔扩张,黏膜层变薄,黏膜皱襞减少。空白组子宫壁和两置器组IUD直接压迫区的子宫壁均可见小血管轻度扩张充血,3组比较无明显差异。心肺肝脾肾组织均未见异常。结论:记忆合金药铜IUD与不锈钢药铜IUD对兔子宫内膜及重要脏器的组织形态学影响相似。     

慢性子宫内膜炎中MMP-2和TIMP-2表达的研究

目的 探讨慢性子宫内膜炎患者子宫内膜中的基质金属蛋白酶-2和组织金属蛋白酶抑制物-2的表达与慢性子宫内膜炎的关系.方法 子宫内膜活检诊断为慢性子宫内膜炎者为实验组共37例,正常对照组30例,采用免疫组化链酶亲和素-生物素-过氧化物酶连接法检测两组子宫内膜基质金属蛋白酶-2和组织金属蛋白酶抑制物-2的表达.结果 实验组子宫内膜腺上皮细胞和间质细胞中基质金属蛋白酶-2和组织金属蛋白酶抑制物-2的表达均低于对照组.实验组基质金属蛋白酶-2在子宫内膜腺上皮细胞(χ2 = 15.7546,P=0.0001)和间质细胞(χ2 =8.6695,P=0.0032)的表达均低于对照组.实验组组织基质金属蛋白酶抑制物-2在子宫内膜腺上皮细胞(χ2 =21.8134,P=0.0000)和间质细胞(χ2 = 8.1883,P=0.0042)的表达也低于对照组.结论 基质金属蛋白酶-2和组织金属蛋白酶抑制物-2表达降低可能与慢性子宫内膜炎有关.     

高强度聚焦超声治疗功能性子宫出血实验研究

目的:应用高强度聚焦超声(HIFU)治疗功能性子宫出血(DUB),观察子宫内膜治疗前后病理改变及孕激素受体(PR)与雌激素受体(ER)的表达,循证HIFU治疗DUB的疗效和作用机制.方法:选取2011年1月～2014年5月在该院自愿接受HIFU治疗并无生育要求的DUB患者42例,治疗前1个月、治疗后1～6个月分别行子宫内膜诊断性刮宫取子宫内膜组织,行HE染色,观察其组织形态学变化及病理类型,同时行免疫组化检测PR及ER的表达水平.结果:HIFU治疗后1～6个月子宫内膜病理切片显示:内膜明显变薄,腺体疏松、萎缩,血管稀少,纤维结缔组织增生;且部分患者治疗后6个月诊断性刮宫刮出物未见明显的内膜组织.HIFU治疗后1～6个月免疫组化检测结果显示:子宫内膜组织中PR、ER的阳性表达率明显低于治疗前,差异有统计学意义(P＜0.05).结论:HIFU对子宫内膜及基底层有实质性的损毁作用,使子宫内膜不能再生而不再发生周期性脱落,将其用于DUB的治疗是一种安全、有效的新方法.     

机械刮宫法建立比格犬宫腔粘连模型

目的：通过机械刮宫法建立稳定的比格犬宫腔粘连的动物模型,以利于进一步研究探索。方法：6只性成熟的健康雌性比格犬的子宫按处理方法不同分为4组。所有经过搔刮处理后2个月的犬右侧子宫角组织作为处理组,搔刮前该部位正常内膜组织、同侧未处理的子宫组织及左侧未处理的相应部位的子宫组织为对照组,分别记为搔刮前组、同侧未处理组、对侧组。通过机械刮宫法损伤右侧子宫角内膜,分别于造模前后收集子宫内膜标本,行苏木精-伊红染色法、Masson染色法及免疫组织化学染色法并进行分析。结果：处理组外观异常的发生率高于对侧组（P＜0.05）;处理组的内膜厚度薄于搔刮前组和对侧组（P＜0.05）;处理组的内膜腺体数目明显比搔刮前组、同侧未处理组和对侧组少（P＜0.05）;处理组的子宫内膜纤维化面积比例显著高于搔刮前组、同侧未处理组和对侧组（P＜0.001）;胰岛素生长因子Ⅰ（IGF-Ⅰ）、转化生长因子β1（TGF-β1）在处理组内膜上的表达水平高于搔刮前组、同侧未处理组和对侧组（P＜0.05）,碱性成纤维细胞生长因子（bFGF）在处理组内膜上的表达水平高于搔刮前组（P＜0.05）。结论：利用机械刮宫法可以建立稳定的比格犬宫腔粘连模型,而子宫内膜组织中的IGF-Ⅰ、TGF-β1和bFGF的异常表达可能参与宫腔粘连的形成。     

卵巢双原发腺癌合并子宫内膜原发腺癌病例分析

<正>现对卵巢双原发腺癌合并子宫内膜原发腺癌1例临床分析如下。1临床资料患者,女,32岁,系"卵巢癌术后32个月,发现盆腔包块1个月"于2011年7月入院。既往2009年因左侧卵巢瘤手术,术后病理:左侧卵巢子宫内膜样腺癌,右侧部分卵巢见癌细胞局灶浸润;腹腔冲洗液见癌细胞;子宫内膜为复杂性增生伴非典型增生。术后卡铂、紫杉醇化疗6个疗程,期间监测CA125正常。入院查体:一般状态好,心肺腹未见异常。专科情况:外阴、阴道及宫颈正常,子宫大小正常,右侧附     

子宫内膜异位症患者子宫内膜雌激素受体与血管内皮生长因子表达的研究

目的:通过测定子宫内膜异位症患者子宫内膜中雌激素受体亚型(ER-α和ER-β)与血管内皮生长因子(VEGF)表达情况,探讨ER与VEGF在子宫内膜异位症发病机制中的作用。方法:通过免疫组化的方法测定ER、VEGF在内异症患者子宫在位内膜与异位内膜中的表达情况。结果:各组内膜中ER-α的表达差异无统计学意义(P>0.05)。内异症在位子宫内膜中ER-β表达率高于对照组子宫内膜,差异有统计学意义(P<0.05)。内异症在位子宫内膜中VEGF表达率高于对照组,差异有统计学意义(P<0.05)。结论:内异症患者在位子宫内膜雌激素受体亚型表达异常,从而调控VEGF的表达,使异位内膜组织易产生新生血管,为异位内膜的生长提供血供。     

宫腔粘连患者子宫内膜基质金属蛋白酶-9(MMP-9)表达的研究

目的:通过对子宫内膜组织中MMP-9表达的研究,探讨宫腔粘连的发病机制。方法:前瞻性研究宫腔粘连组(观察组)和非宫腔粘连组(对照组)患者各30名,通过免疫组化半定量测定两组子宫内膜组织中基质金属蛋白酶-9(MMP-9)的表达水平。结果:观察组子宫内膜MMP-9的表达明显低于对照组,且两组子宫内膜MMP-9的表达有非常显著差异(P=0.000<0.01);在观察组中重度宫腔粘连患者子宫内膜MMP-9的表达明显低于轻、中度宫腔粘连患者,两者间子宫内膜MMP-9表达也有显著差异(P<0.05)。结论:子宫内膜组织中MMP-9的异常表达可能参与宫腔粘连的形成。     

联合检测子宫内膜中DNA、CEA、EMA、KT及端粒酶诊断子宫内膜癌

目的检测子宫内膜癌的DNA含量,细胞膜抗原定位和端粒酶的研究.方法以流式细胞仪检测32例子宫内膜癌的DNA含量、以免疫组化方法检测细胞膜抗原癌胚抗原(CEA)、上皮膜抗原(EMA)、角蛋白(KT)在子宫内膜癌上的定位,以原位杂交方法检测端粒酶活性.结果DNA含量及SPF值是判定子宫内膜组织分化程度的重要指标;细胞膜抗原在子宫内膜癌中高表达;端粒酶在子宫内膜癌组织中活性显著增高,与正常内膜组织相比P＜0.05.结论DNA非整倍体是子宫内膜癌分子生物学的特异性标志;细胞膜抗原在子宫内膜癌中的阳性染色分布特点是其诊断的重要标志;端粒酶活性增高在子宫内膜癌的临床诊断中有重要意义,可能成为早期诊断的指标.     

Effect of Rabbit Spermatozoa on the Incorporation of Labeled Precursors into Endometrial Macromolecules

The presence of rabbit spermatozoa in the uterine horn of the doe over a 10-hr period induced an increase in the incorporation of leucine-¹⁴C and orotate-³H [from 230 ± 50 to 520 ± 32 and 146 ± 41 to 432 ± 40 (dpm 10³ mg DNA; Mean ± SEM)] into endometrial proteins and nucleic acids. The addition of actinomycin D or cyclohexamide significantly inhibited this process. The intraluminal administration of dibutyryl cyclic AMP (dbcAMP) (control group) induced an increase two times greater than that produced by spermatozoa. The increase in the incorporation of radioactive precursors into endometrial macromolecules induced by the spermatozoa is independent of the uterine carbonic anhydrase activation produced by this cell.     

Local progestational effect of norgestrel in an intrauterine Silastic capsule

A Silastic® device containing norgestrel, placed in an isolated segment of one uterine horn of the ovariectomized rabbit, produced an equal degree of endometrial proliferation in both horns during the first ten days after insertion. However, from day 14 through day 150 the progestational effect was limited to the segment containing the Silastic device; during the same time period, the contralateral horn remained unstimulated. These results show that the low release of norgestrel from a Silastic device produces a localized progestational effect for at least a five-month period.     

In vivo study of the embryotoxic activity of leukocytes

The embryotoxic activity of polymorphonuclear leukocytes (PMNLs), macro-phages abd endometrial cells was studied $\text{in vivo.}$Rabbits were mated, both uterine horns were ligated at the cervical end, and different concentrations of intact or homogenized cells were injected in one horn while the other served as control. The fertility rate, size of implantations and number of cells in uterine flushings were assessed 10 days postcoitum.PMNLs, macrophages, and endometrial cells exhibited a potent antifertility effect, retarded post-implantation growth and attracted large numbers of white cells. A definite dose and effect relationship between the concentration of cells and the different parameters was demonstrated. Phagocytosis did not play a role in this system.The embryotoxic effect is not limited to uterine cells since it could also be demonstrated in liver, thyroid and red blood cells.     

芳香化酶抑制剂对异位子宫内膜间质细胞NO/ET表达的影响和意义

目的:探讨NO/ET与异位子宫内膜间质细胞凋亡的关系以及芳香化酶抑制剂依西美坦的作用。方法:体外培养原位和异位子宫内膜间质细胞,应用发光免疫法检测雌二醇的水平,应用ELISA检测内皮素表达,用硝酸还原酶法检测一氧化氮,应用流式细胞仪检测细胞的凋亡。结果:与正常内膜间质细胞相比,异位内膜间质细胞可以合成雌激素,其NO和ET合成相应增加,但NO/ET比值下降,细胞凋亡率也相应降低(P<0.05)。依西美坦作用72 h后,异位内膜间质细胞雌激素合成减少,NO/ET比值增加,凋亡率相应升高(P<0.05)。结论:NO/ET比值可以预测异位子宫内膜间质细胞的凋亡情况,依西美坦可升调NO/ET比值并增加异位内膜间质细胞的凋亡。     

镍钛记忆合金硅橡胶可复性输卵管避孕栓的动物实验研究

目的:应用镍钛记忆合金硅橡胶可复性输卵管栓进行动物实验研究,观察其抗生育效果和取栓后生育力恢复情况。方法:新西兰成年雌兔(实验组30只、对照组5只),经腹暴露子宫后,子宫近输卵管1cm处做一纵向0．5cm切口,将输卵管栓放入特制放置器顶端,顺序推出内部针芯、外部套管,使栓子留在输卵管内。术后1个月开始与雄兔合笼,每周交配1次(每月交配4次),观察避孕效果,术后3个月10只雌兔取出输卵管栓子观察可复性。结果:栓子放置术后2个月,30只雌兔中除1 只因栓子放置位置不当而妊娠外,其余29只均未妊娠。10只取出栓子后1个月内交配3次均妊娠。结论:镍钛记忆合金硅橡胶可复性输卵管避孕栓是一种新型、有效和可复性的输卵管避孕器具。     

可逆性输卵管节育器对新西兰兔子宫、输卵管组织病理学影响的研究

目的：通过放置可逆性输卵管节育器，研究放置后子宫、输卵管黏膜的组织病理变化，了解可逆性输卵管节育器对局部组织的影响，判断该器械的可行性和安全性。方法：将6—8月龄体重3．5—4kg的新西兰大白兔32只随机分为4组，受试器械组输卵管内放置新型可逆性节育器；阳性对照组子宫内放置“新爱母”宫内节育器；假手术组只行手术不放置任何器械；阴性对照组不做任何处理。4组在同一环境下进行饲养、称重、取血等操作。手术后1个月，手术剥离新西兰兔子宫、输卵管行HE染色作组织病理学检查。结果：病理切片可见受试器械组、阳性对照组、假手术组子宫内膜上皮，输卵管均见炎细胞侵润，局部组织水肿，子宫腺体基本正常，周围部分固有层水肿；而阴性对照组子宫、输卵管黏膜结构整齐，腺体排列规整，未见炎细胞侵润。结论：输卵管放置节育器对局部组织无明显损伤，各手术组均见炎细胞侵润为手术所致。     

No transuterine migration of fertilised ova after unilateral embryo transfer in mice

Transuterine migration is the passage of fertilised ova from one uterine horn into the other. The phenomenon has been described for animals of different species with a bicornuate type of uterus. Whether or not it occurs in rodents is questionable, but could have an impact on the way embryo transfers are carried out, i.e. unilaterally or bilaterally. The aim of this study was to examine the occurrence of transuterine migrations in nulliparous and multiparous mice after unilateral embryo transfer. Sixteen two-cell embryos were transferred into either the left or the right oviduct of mice with different genetic origin. With the exception of one reabsorption site in the opposite uterine horn, we never found evidence for the occurrence of transuterine migration. This is also true for embryo transfers carried out after parturition of the surrogate mother. Even the successful development of up to 13 embryos in one uterine horn did not result in transmigration but may be the reason for the widespread assumption that transuterine migration occurs after unilateral embryo transfers. The separation of the uterine body and the prevaginal portion of the uterine cervix into two canals by a septum seems to be the main reason for the absence of successful transuterine migration in mice.     

Blastocidal and contraceptive actions by an extract and compounds from endod (Phytolacca dodecandra)

An extract consisting primarily of the saponins derived from the Endod plant (Phytolacca dodecandra), three purified trisaccharides derived from the extract, and a synthetic disaccharide were tested for antifertility activity on Days 1, 4, and 6 of pregnancy. Known quantities of the crude extract or purified compounds were injected into one of the two uterine horns of rats, and the contralateral horn served as a control. Separate control groups received physiological saline in one of the two horns. Vaginal smears were routinely observed each morning, and the presence of vaginal sperm determined Day 1 of pregnancy. Then, intrauterine injections were performed by surgery on Days 1, 4, and 6 of pregnancy. Treatment with proper dose levels of the crude saponin extract, lemmatoxin, and oleanoglycotoxin-A was found to be capable of preventing pregnancy or reducing the embryonic count on all three days. Lemmatoxin-C-C' was also tested on Day 1 and found effective at proper dose levels. On Days 1 and 4, oleanolic acid cellobioside had little or no effect on pregnancy when injected in utero at doses up to 1,000 μg. Endod extract caused substantially lower decreases in surface tension of water than Nonoxynol-9, yet showed 5 to 10 times the antifertility activity when administered on Day 1. To test whether a substance acted on the uterine horn to prevent implantation, Endod extract was injected on Day 1 into one of two uterine horns at a high level, sufficient to prevent pregnancy on the treated side. When the oviducts were flushed the third day after mating, 4 out of 5 rats had embryos on the treated side which were in similar stages of development as on the untreated side. Under the conditions of these experiments, there was no obvious damage to the uterine endometrium observed histologically due to treatment with purified compounds. It is suggested that this or related classes of compounds may be useful as abortifacients during early stages of pregnancy.     

三维超声结合血清β-绒毛膜促性腺激素在残角子宫妊娠孕早期诊断中的应用

目的:分析三维超声结合血清β-绒毛膜促性腺激素(β-hCG)在残角子宫妊娠孕早期诊断中的应用。方法:选择经超声或手术病理诊断的10例残角子宫妊娠患者纳入残角子宫妊娠组,选取同期孕检正常的35名宫内妊娠者纳入正常子宫妊娠组,对两组分别采用血清β-hCG检测、三维超声检查和两者联合检测的3种方法进行残角子宫妊娠检测,比较两组血清β-hCG水平、子宫内膜厚度差异和3种方法检测残角子宫妊娠的准确率。结果:残角子宫妊娠组血清β-hCG平均水平低于正常子宫妊娠组,差异有统计学意义(t=17.472,P<0.05);残角子宫妊娠组子宫内膜厚度平均水平低于正常子宫妊娠组,差异具有统计学意义(t=7.555,P<0.05);联合检测残角子宫妊娠的准确率高于血清β-hCG检测和三维超声单独检查,差异具有统计学意义(x²=7.561,x²=10.956;P<0.05)。结论:三维超声检查方法操作简单、便捷,与血清β-hCG联合检查,能够提高诊断的准确率,减少误诊和漏诊的发生,可预防子宫破裂、不必要的引产及后期胎儿死亡等并发症。