探讨α-亚麻酸(ALA)对戊酸雌二醇(EV)诱导的多囊卵巢综合征大鼠的性激素水平及卵巢组织形态的影响.32只SD大鼠分为4组:对照组、模型组、ALA 50 mg/kg组和ALA 200 mg/kg组,每组各8只.采用HE染色方法观察大鼠卵巢组织形态,ELISA法检测血清中雌二醇(E2)、孕酮(P)、睾酮(T)和脱氢表雄酮(DHEA)含量.结果表明,与模型组大鼠比较,ALA处理组大鼠卵巢质量、E2、T水平均显著降低,P、卵巢组织中成熟卵泡数量及黄体数量均显著增多,且ALA均呈剂量依赖效应.ALA 200 mg/kg组大鼠卵巢组织中CYP11A1 mRNA含量低于模型组,差异具有统计学意义(P<0.05).总体说明,ALA可明显改善戊酸雌二醇诱导的多囊卵巢综合征大鼠的卵巢组织形态,增加成熟卵泡及黄体数量,调节血清中性激素含量,降低卵巢组织中CYP11A1 mRNA表达.

The concept of enhanced recovery after surgery has been widely used in various disci-plines. Because of the need of anaesthesia and metabolism after surgery and the particularity of gynecologi-cal pelvic surgery, most surgical operations require indwelling catheter. However, indwelling catheter has many complications, such as urinary tract infection, difficult intubation, leakage, bladder function damage and difficult extubation. This article mainly discussed the progress of rehabilitation surgery and the applica-tion of early removal of ureter, and discussed the complications of indwelling catheter, in order to shorten the time of indwelling catheter after surgery, so as to reduce the symptoms of urinary tract irritation, the rate of urinary tract infection, and the nervous and anxious mood of patients, as well as accelerate the recovery of patients after surgery.

Pelvic abscess is one of the most common gynecologic acute abdomen.It is often developed by pelvic inflammatory disease,and the incidence of the pelvic abscess is rising year by year and younger.It often leads to a variety of diseases,such as infertility,which threaten female reproductive health.Its clinical symptoms vary and progress rapidly,which can easily lead to misdiagnosis or untimely rupture of abscess,and seriously endanger life.For pelvic abscess,correct diagnosis and timely treatment are the fundamental starting point.This article reviews the progress in the diagnosis and treatment of pelvic abscess.

High mobility group protein B1 (HMGB1) is a DNA binding protein that can induce cytokines to be secreted and activate inflammatory cells to participate in inflammatory reactions. Recent studies on its role in the inflammatory response to endometriosis have gradually increased. Endometriosis is a benign inflammatory disease with increasing incidence year by year, mostly in women of childbearing age. This disease mainly causes the clinical manifestations of dysmenorrhea and chronic pelvic pain. Endometriosis usually plays a synergistic role in inflammatory immune, lesion tissue invasion, adhesion and other factors, resulting the changes in the pelvic microenvironment. The mechanism of endometriosis is not completely clear, but the role of inflammatory reaction and stimulation can not be ignored. HMGB1 can increase the release of inflammatory factors and cause the body to produce pain, and the expression of HMGB1 in the endometriosis patients is significantly increased. The inflammatory response and pain can be alleviated by reducing the concentration of HMGB1 in the body of endometriosis patients. Pain and other symptoms suggest that HMGB1 may become an important target for the treatment of endometriosis.

子宫内膜异位症(EMs,简称内异症)是一种症状和外观表现多样的异质性疾病.不孕是EMs最常见的症状之一,常合并盆腔疼痛.内异症相关不孕发病率高达50%,但具体机制尚不明确.免疫机制是EMT的发病机制之一,关于EMs免疫机制引起不孕的研究日益增多,特别是单核-巨噬细胞免疫系统.对EMs相关不孕的发病机制进行深入研究,可能有助于发展有针对性的治疗方法和改进诊断方法.

Objective To study the antibiotic function of inducing the E.coli to Cryptic Growth Cells(CGC)and its correlation with pelvic abscess.Methods Establish the models of pelvic inflammatory disease(PID);Use the SD female rats as research subjects;inculate the E.coli on the mesosalpinx;observe the pathological changes of reproductive system;determine the acute exacerbation.Establish PID acute exacerbation models and divide them into 4 groups:one for control and the other 3 for experiment.Use 1/2 concentration antibiotics to induce the CGC to simulate denormalized treatment.Observe the pathological change and CGC.Results In the PID models,the pathological change and time had positive correlation.Among these models,the course of PID was divided into acute and chronic stage.The acute exacerbation was defined as the range between 7th to 17th days after modeling,but there was no suppuration during that time.CGC was found from the models which were injected 1/2 concentration of cephalosporins during the acute exacerbation.At the same time,lesions appeared suppuration and serious tissue damage.Conclusion CGC can be induced by nonstandard antibiotic treatment for PID,which may induce pelvic abscess.

目的：：探讨妇女宫腔积脓的病因、诊断、治疗及预防。方法：回顾分析哈尔滨医科大学附属第二医院收治的37例宫腔积脓患者的病史、临床表现、辅助检查及诊治情况。结果：宫腔积脓以绝经后老年女性多见,未绝经患者多合并严重的阴道炎症、子宫内膜炎等。37例患者中,手术患者13例,其中合并穿孔感染性腹膜炎及感染性休克患者1例,1例患者术后诊断为宫颈癌,术前诊断明确的子宫恶性肿瘤患者7例,引流失败行全子宫切除3例,子宫脱垂患者1例。宫腔镜及超声引导下置管引流成功10例,宫腔镜下冲洗14例。37例患者均进行对症抗感染治疗,除恶性肿瘤患者,其余均已治愈。结论：宫腔积脓在临床上并不多见,症状不典型,易误诊,可引起严重并发症,应针对病因早期诊断、早期治疗。

Cervicalcanceristhemostcommonmalignanttumorofthefemalereproductionsystem.At present,clinical therapies of cervical carcinoma mainly include surgery,radiotherapy and chemotherapy. How-ever,clinical efficacy is not satisfactory. Recent investigations have focused upon alternative modalities. Hu-man papilloma virus (HPV)infection is the major cause of cervical cancer. HPV-induced malignancy is mainly correlated with E5 ,E6 and E7 oncogenes. Inhibition of E6 and E7 oncogenes is a promising biological strategy for cervical cancer. This article reviews research progress on biological treatment of cervical cancer such as im-munotherapy,molecular targeted and gene therapies.

子宫内膜异位症( EMs)是常见的妇科良性疾病，却具有侵袭、转移等特性。 PI3K/Akt/mTOR和MAPK信号通路是两条重要的细胞内信号转导通路，在多种细胞反应中发挥着重要作用。研究显示，在 EMs 中存在 PI3K/Akt/mTOR 和 MAPK 信号通路的过度激活，并通过调节细胞黏附分子( CAM)、基质金属蛋白酶( MMP)、血管内皮生长因子( VEGF)及凋亡因子等的表达，影响异位内膜的黏附、侵袭，血管生成及凋亡，并受激素水平的调控，促进了子宫内膜细胞的异位侵袭和转移，与EMs的发生、发展密切相关。

子宫内膜异位症(endometriosis,EMs)是一种常见的妇科良性疾病,在育龄妇女中的发病率为6％ ～ 10％,20％ ～ 50％不孕患者患有EMs[1].EMs发病机制尚不明确,研究发现凋亡在EMs的发生、发展中具有重要作用.EMs患者子宫内膜细胞凋亡减少伴随着凋亡抑制因子增加和凋亡促进因子减少.提示内膜细胞对凋亡的易感性降低.提高其在异常部位的生长能力,最终导致EMs的发生[2].现综述凋亡与EMs发病及治疗的研究现状。

本文报道一例不完全性阴道横隔并阴道积脓、宫内早孕患者,24岁,因"停经54天,发现阴道流出脓液9天"入院.宫腔镜检查确定为不完全性阴道横隔并阴道积脓.宫腔镜手术联合抗生素治疗治愈.妊娠期阴道微环境受激素影响而改变,并发阴道畸形更易致感染,宫腔镜是此类疾病诊治的首选方式,效果较好.

盆腔炎性疾病(PID)是指病原菌感染女性上生殖道后引起的盆腔器官及其周围组织的炎症性疾病.表达于生殖道的先天性免疫防御系统Toll样受体(TLRs),能识别病原相关分子模式(PAMPs),并能激活抗感染的基因表达,促使炎症因子释放.TLRs是将感染、炎症和损伤联系起来的关键.研究发现,PID常见病原菌感染机体后可激活不同类型TLRs,通过特定信号转导通路激活机体免疫应答反应,促进炎性因子的释放.本文对病原菌感染机体后TLRs的激活及炎性因子的释放方面做一综述.

目的 探讨CA199和CA125水平与卵巢成熟畸胎瘤的相关性.方法 选择2011年7月至2012年4月有病理确诊的卵巢成熟畸胎瘤或卵巢癌321例,回顾分析其各项临床资料,同时测定CA199、CA125水平,从肿瘤大小、成分等方面进行分析,寻找卵巢成熟畸胎瘤与血清CA199、CA125水平增高的相关因素.结果 血清CA199水平与卵巢成熟畸胎瘤的大小、组织成分等因素有明显的相关性.尽管CA199的升高在卵巢成熟畸胎瘤和卵巢癌中没有明显的差别,但其平均值前者较高;此外,卵巢恶性肿瘤中,CA125和CA199的同时升高比CA199的单独升高更显著.结论 对于卵巢成熟畸胎瘤的患者,CA199是重要的诊断方法;CA199结合CA125是用于鉴区别卵巢成熟畸胎瘤和卵巢癌的重要指标.

目的:探讨HPV16 E6小干扰RNA (siRNA)对宫颈癌SiHa细胞增殖的影响.方法:利用化学合成的方法,合成针对HPV16 E6的siRNA,借脂质体转染SiHa细胞.应用荧光定量RT-PCR和Western-blot检测HPV16 E6 mRNA及其蛋白水平的表达.MTT法绘制细胞生长曲线.流式细胞术评价HPV16 E6 siRNA对细胞周期的影响.结果:HPV16 E6 siRNA转染细胞48h及72h后,细胞内HPV16 E6 mRNA及蛋白表达量明显下调,与HPV16 E6阴性对照组及空白组比较[48h(1.85±0.15)vs (2.14±0.13),(2.29±0.11);72h (1.82±0.06)vs(2.32±0.14),(2.35±0.23)],差异有显著性意义(P＜0.01);MTT显示细胞生长明显受到抑制;流式细胞术检测显示,E6 siRNA可将细胞阻滞在G1期.结论:HPV16 E6 siRNA能抑制SiHa细胞增殖.

报道1例T2DM合并盆腔脓肿及脑脓肿患者,因“闭经伴下腹胀2年,发现盆腔包块10余天”入院.既往体健,未发现糖尿病.查体发现下腹部轻压痛,阴道黄色脓性分泌物.75 g OGTT确诊T2DM.盆腔脓肿、脑脓肿均经病灶切除术后病理证实.胰岛素、手术综合抗生素治疗有效.糖尿病与感染两者相互作用,同时治疗效果更佳.

Objective: To evaluate the feasibility of combined with uterine artery embolization( UAE) in cesarean car pregnancy( CSP). Methods: Retrospective analysisof 19 cases of patients with CSP( CSP diameter 6 cm or less by ultrasound) from January2011 to January 2013. All cases were received the UAE and arterial injection of methotrexate( MTX). When the blood beta HCG fell to about 1000 U /L and thickness of the lesions to serous membrane were≥0. 2 cm by ultrasound,pregnancy lesions were resected by hysteroscopy surgery. Results: ① The duration of UAE surgery combined with artery injection MTX was about20 minutes,without injury or other emergency. Blood beta HCG levels decreased from 17804. 76 ±11713. 55 U /L to 988. 54 ±165. 83 U /L before hysteroscopy surgery,and lesion diameter decreased from 3. 64±1. 01 cm to 3. 13±0. 98 cm. ②Hysteroscopy surgery duration was 18 to 40 min,and theintraoperative blood loss was 17. 37±7. 32 ml,without transit operation,intraoperative complication and injury. Postoperative blood beta HCG decreased to 112. 71±35. 16 U /L within 2 ~ 4 days. Menstruation restored after 30 to 45d. Conclusions: Hysteroscopy surgery with pretreatment of UAE combined with MTX injection could achieve satisfactory outcome for CSP,which should become one of the appropriate choice for CSP patients.

癌症已经成为威胁人类健康的最主要也是最严重的疾病。现代研究表明,癌症的发生与原癌基因的激活和抑癌基因的失活或突变以及抗凋亡基因过度表达有关。近年来的研究表明原癌基因c-fos和c-jun在控制细胞生长和分化中起着关键性的调节功能,笔者从常见癌症中c-fos和c-jun蛋白的表达以及两者的相关性等方面探讨二者在癌症的发病机制中的作用。

Objective: To study the expression and significance of IP-10(IFN-T-mducible Protein-10) in ovarian epithelial cancer.Methods: The concentrations of IFN-γ-mducible Protem-10 in blood serum were detected by means of ELISA respectively m 20 cases of patients with ovarian epithelial benign tumors and 48 cases of ovarian epithelial tumors,and 20 cases of healthy persons serve as the control.Results: The serum levels of IP-10 in patients with ovarian epithelial cancer(3.516pg/ml±1.349pg/ml) were lower than in patients with epithelial benign tumor(63.723 pg/ml±9.692 pg/ml) and normal people(70.077 pg/ml±11.034 pg/ml,P0.01).The serum levels of IP-10 in patients with ovarian epithelial cancer correlated with their clinical stage(P0.05) and histology grade(P0.05).The serum levels of IP-10 in patients with ovarian epithelial cancer did not correlated with pathologic typing(P0.05).Conclusion: IP-10 were lower expressed in ovarian epithelial cancer,and they have correlation with invasion and metastasis,and they have some correlation with clinical pathology and prognosis of epithelial ovarian cancer.

干扰素诱导蛋白10(IFN-γ-inducible Protein,IP-10)是新近发现的一种趋化因子,具有多种生物学功能.以往的研究多集中IP-10的来源、结构及其作为一种趋化因子介导Th1型反应,近年来人们更加注重研究IP-10诱导胸腺依赖性的抗肿瘤免疫反应和作为一种血管新生抑制因子在肿瘤的发生和治疗中的作用.本文综述了IP-10及其受体CXCR3与肿瘤关系的研究进展.