Objective： To study the effect of levobupivacaine and bupivacaine on the contractility of isolated uterine muscle strips from pregnant and non-pregnant female rats. Methods： Full-thick myometrial strips were prepare...Objective： To study the effect of levobupivacaine and bupivacaine on the contractility of isolated uterine muscle strips from pregnant and non-pregnant female rats. Methods： Full-thick myometrial strips were prepared from 18- to 2 l-day pregnant （n=8） and non-pregnant rats （n=7）. After contractions became regular, strips were exposed to cumulative concentrations of the two drugs from 10^-8 to 10^-4 mol/L, amplitude and frequency of the uterine contraction was recorded. Results： Two local anesthetics caused a concentration dependent inhibition on contractility of myometrial strips from pregnant and non-pregnant rats. In the myometrium from non-pregnant rats, -log/C50 of levobupivacaine and bupivacaine were 4.85 and 4.25 respectively. In the myometrium from pregnant rats, similar concentrations of levobupivacaine and bupivacaine were observed, -log/C50 were 2.7 and 2.9 respectively. Levobupivacaine produced an increase in amplitude of contractions, while bupivacaine showed an increased trend in frequency. Conclusion： These results demonstrate that levobupivacaine and bupivacaine may inhibit myometrium contractility. The inhibitory effect of levobupivacaine or bupivacaine is not enhanced by gestation in rat. Levobupivacaine may have more positive influence than bupivacaine in pregnant myometrium.展开更多
In order to investigate the expression of cyclooxygenase-2 (COX-2) in human lower segments of myometrium obtained from women in labor and those not in labor and identify the splicing variant of COX-2, reverse transcri...In order to investigate the expression of cyclooxygenase-2 (COX-2) in human lower segments of myometrium obtained from women in labor and those not in labor and identify the splicing variant of COX-2, reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect the expression of COX-2. The primers were designed and synthesized according to the sequence of rat COX-2 splice variant which was discovered firstly by us. Then the splicing variant of COX-2 in human myometrium from woman in labor was identified, cloned into vector and sequenced. The results showed that the expression of COX-2 mRNA was lower in human myometrium obtained from women who were not in labor than that in labor women and a new band of COX-2 was obtained in myometrium from labor woman. The fragment included an unspliced intron, which pitched between exons 7 and 8. It was suggested that COX-2 gene was not only expressed highly in human myometrium from woman in labor, but also produced splicing variant by alternative splicing.展开更多
Malignant melanomas or lymphoma of the skin are malignant tumors of the skin and/or the mucous membranes whose uterine metastases are rare. The secondary uterine localizations, although rare, must be evoked in front o...Malignant melanomas or lymphoma of the skin are malignant tumors of the skin and/or the mucous membranes whose uterine metastases are rare. The secondary uterine localizations, although rare, must be evoked in front of a pelvic tumoral syndrome, or diffuse metastases and a personal past history of melanoma, even after a long time of remission. In our observation, the evolution of the tumor in the pelvis extended to the muscular structures of the uterus and the sigmoid colon of a 72 year old patient, what made it an exceptional case. The diagnosis of these secondary localizations is a diagnosis of elimination, almost always post-operative, made on the histopathological and immunocytochemical study of the surgical specimen, supported by cytogenetics, even molecular biology. The treatment is based on chemotherapy.展开更多
Background: Xanthogranulomatous inflammation of the female reproductive organs is a rare chronic inflammation. In most reported cases, the lesion was limited to the endometrium and fallopian tubes. Here, we report two...Background: Xanthogranulomatous inflammation of the female reproductive organs is a rare chronic inflammation. In most reported cases, the lesion was limited to the endometrium and fallopian tubes. Here, we report two cases of xanthogranulomatous inflammation of the myometrium with a history of endometrial biopsy. Case Reports: In two cases, myometrial xanthogranulomatous inflammation destroyed the myometrium. This inflammation developed into surrounding pelvic organs, resulting in uterine perforation. Conclusion: When inflammatory lesions are found after intrauterine manipulation, the possibility of developing xanthogranulomatous inflammation should be considered. If antibiotics are ineffective, prompt surgical treatment is necessary.展开更多
Adenomyosis is a common gynecological disease characterized by the invasion of endometrial glands and stroma into the myometrium of uterus,the pathological mechanism of which remains unclear yet.Disturbed lipid metabo...Adenomyosis is a common gynecological disease characterized by the invasion of endometrial glands and stroma into the myometrium of uterus,the pathological mechanism of which remains unclear yet.Disturbed lipid metabolism extensively affects abnormal cell proliferation and invasion in various diseases.However,the lipidome signature of human myometrium,which could be crucial in the development of adenomyosis,remains unknown.In this study,we generated the first lipidome profiling of human myometrium using a high-coverage and quantitative lipidomics approach based on ultraperformance liquid chromatography(UPLC)coupled with triple quadrupole(QqQ)-mass spectrometry(MS).A total of 317 lipid species were successfully quantified in the myometrial tissues from women with(n=38)or without(n=65)adenomyosis who underwent hysterectomy at Peking Union Medical College Hospital(Bejing,China).Up to 83 lipid species showed significant alternations in content between the two groups.These lipid aberrations involved multiple metabolic pathways,and emphasized inflammation,cell migration,and immune dysregulation upon adenomyosis.Moreover,receiver operating characteristic(ROC)curve analysis found that the combination of five lipid species could accurately distinguished the myometrial samples from women with and without adenomyosis with an area under the curve(AUC)of 0.906.Desorption electrospray ionization MS imaging(MSI)further underscored the heterogeneous distributions of these lipid markers in the adenomyosis lesion and adjacent myometrial tissue.Collectively,these results extremely improved our understanding on the molecular basis of adenomyosis,and could shed light on developing potential biomarkers and new therapeutic directions for adenomyosis.展开更多
目的:根据世界卫生组织(World Health Organization,WHO)的分析报告,全球不孕症患病率呈逐年上升趋势。分析造影剂逆流子宫肌层的相关风险因素,对降低造影剂逆流的发生率及治疗女性不孕症具有重要的意义。目前,临床上缺乏预评估输卵管...目的:根据世界卫生组织(World Health Organization,WHO)的分析报告,全球不孕症患病率呈逐年上升趋势。分析造影剂逆流子宫肌层的相关风险因素,对降低造影剂逆流的发生率及治疗女性不孕症具有重要的意义。目前,临床上缺乏预评估输卵管造影逆流子宫肌层的有效指标,判断标准主要依赖于医生经验和患者症状。本研究旨在运用四维超声子宫输卵管造影的影像学特征来评价造影剂逆流子宫肌层的危险因素,并构建诺模图(nomogram)风险预测模型,为临床不孕症的诊疗提供参考。方法:本研究回顾性分析2020年1月1日至2022年12月15日在湖南妇女儿童医院和中南大学湘雅三医院就诊的1274例行四维子宫输卵管超声造影(hysterosalpingo-contrast sonography,HyCoSy)手术检查的不孕症女性患者的影像学特征。将发生造影剂逆流子宫肌层的不孕症患者设为逆流组(n=234),未发生造影剂逆流子宫肌层的不孕症患者设为未逆流组(n=1040)。对研究的基线变量与造影剂逆流子宫肌层结局依次采用单因素Logistic分析和多因素Logistic分析,筛选出有统计学意义的变量构建nomogram预测模型。通过Bootstrap分析进行内部验证,重复抽样次数为500。结果:未逆流组与逆流组的年龄分别为(30.66±4.83)和(31.82±5.27)岁,差异有统计学意义(P=0.0011)。未逆流组的不孕症类型以原发性不孕为主(50.96%),逆流组则以继发性不孕为主(76.50%),且72.65%的患者存在妇科手术史,组间差异均有统计学意义(均P<0.001)。逆流组出现月经量异常和主观不适情况的患者比例高于未逆流组,而未逆流组则较逆流组使用造影剂更多,差异均有统计学意义(P=0.0016、P<0.001、P<0.001)。在影像学方面,未逆流组与逆流组在内膜厚度、输卵管管壁光滑程度和卵巢周围造影剂弥散程度等方面存在不同,表现为未逆流组内膜厚度更厚,输卵管管壁更光滑、更通畅。Nomogram预测模型的受试者操作特征曲线的曲线下面积(area under the curve,AUC)为0.854,提示预测性能较好。模型内部验证的决策曲线分析(decision curve analysis,DCA)的AUC为0.737,当患者发生造影剂逆流子宫肌层的阈值概率为0.05~0.95时,净收益最高达0.18;应用nomogram预测模型的净收益水平高于全干预和全不干预的附加效益,提示该模型具有较好的临床预测效能。结论:基于不孕症类型、内膜厚度、造影剂量和主观不适等影响因素构建的nomogram预测模型能够准确预测四维HyCoSy术后造影剂逆流子宫肌层的发生风险,有助于临床医生尽早采取预防措施,降低造影剂内渗发生率及其他并发症的发生率。展开更多
目的探讨子宫腺肌症(adenomyosis,AM)患者子宫肌层平滑肌组织中缩宫素受体(oxytocin receptor,OTR)的表达水平与痛经程度的关联性。方法收集2013年9月-2014年8月在本院妇科因AM行全子宫切除手术的腺肌症患者50例为腺肌症组,同期因子宫...目的探讨子宫腺肌症(adenomyosis,AM)患者子宫肌层平滑肌组织中缩宫素受体(oxytocin receptor,OTR)的表达水平与痛经程度的关联性。方法收集2013年9月-2014年8月在本院妇科因AM行全子宫切除手术的腺肌症患者50例为腺肌症组,同期因子宫肌瘤行全子宫切除的患者20例为对照组。应用免疫组化染色法(S-P法)检测20例正常子宫肌层、50例子宫腺肌症肌层平滑肌组织中的OTR表达情况。采用光学显微镜及Image Plus Pro 6.0图像分析系统测定OTR水平,并对其差异进行分析。结果 AM组子宫肌层平滑肌组织中OTR的表达高于对照组(62 370±34 758 vs 16 082±11 125,P<0.01),且表达强度随着痛经程度的加重而增加,差异均有统计学意义。结论 OTR在AM患者子宫肌层平滑肌组织中的表达与痛经程度呈正相关,推测患者痛经形式可能为宫缩痛,表明宫缩强度的增加参与了AM疼痛的发病机制。展开更多
基金Project (No. 2005038281) supported by the Postdoctor Foundationof China
文摘Objective： To study the effect of levobupivacaine and bupivacaine on the contractility of isolated uterine muscle strips from pregnant and non-pregnant female rats. Methods： Full-thick myometrial strips were prepared from 18- to 2 l-day pregnant （n=8） and non-pregnant rats （n=7）. After contractions became regular, strips were exposed to cumulative concentrations of the two drugs from 10^-8 to 10^-4 mol/L, amplitude and frequency of the uterine contraction was recorded. Results： Two local anesthetics caused a concentration dependent inhibition on contractility of myometrial strips from pregnant and non-pregnant rats. In the myometrium from non-pregnant rats, -log/C50 of levobupivacaine and bupivacaine were 4.85 and 4.25 respectively. In the myometrium from pregnant rats, similar concentrations of levobupivacaine and bupivacaine were observed, -log/C50 were 2.7 and 2.9 respectively. Levobupivacaine produced an increase in amplitude of contractions, while bupivacaine showed an increased trend in frequency. Conclusion： These results demonstrate that levobupivacaine and bupivacaine may inhibit myometrium contractility. The inhibitory effect of levobupivacaine or bupivacaine is not enhanced by gestation in rat. Levobupivacaine may have more positive influence than bupivacaine in pregnant myometrium.
基金This project was supported by grants from National Natu ral Sciences Foundation of China ( No. 30070929,30271363).
文摘In order to investigate the expression of cyclooxygenase-2 (COX-2) in human lower segments of myometrium obtained from women in labor and those not in labor and identify the splicing variant of COX-2, reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect the expression of COX-2. The primers were designed and synthesized according to the sequence of rat COX-2 splice variant which was discovered firstly by us. Then the splicing variant of COX-2 in human myometrium from woman in labor was identified, cloned into vector and sequenced. The results showed that the expression of COX-2 mRNA was lower in human myometrium obtained from women who were not in labor than that in labor women and a new band of COX-2 was obtained in myometrium from labor woman. The fragment included an unspliced intron, which pitched between exons 7 and 8. It was suggested that COX-2 gene was not only expressed highly in human myometrium from woman in labor, but also produced splicing variant by alternative splicing.
文摘Malignant melanomas or lymphoma of the skin are malignant tumors of the skin and/or the mucous membranes whose uterine metastases are rare. The secondary uterine localizations, although rare, must be evoked in front of a pelvic tumoral syndrome, or diffuse metastases and a personal past history of melanoma, even after a long time of remission. In our observation, the evolution of the tumor in the pelvis extended to the muscular structures of the uterus and the sigmoid colon of a 72 year old patient, what made it an exceptional case. The diagnosis of these secondary localizations is a diagnosis of elimination, almost always post-operative, made on the histopathological and immunocytochemical study of the surgical specimen, supported by cytogenetics, even molecular biology. The treatment is based on chemotherapy.
文摘Background: Xanthogranulomatous inflammation of the female reproductive organs is a rare chronic inflammation. In most reported cases, the lesion was limited to the endometrium and fallopian tubes. Here, we report two cases of xanthogranulomatous inflammation of the myometrium with a history of endometrial biopsy. Case Reports: In two cases, myometrial xanthogranulomatous inflammation destroyed the myometrium. This inflammation developed into surrounding pelvic organs, resulting in uterine perforation. Conclusion: When inflammatory lesions are found after intrauterine manipulation, the possibility of developing xanthogranulomatous inflammation should be considered. If antibiotics are ineffective, prompt surgical treatment is necessary.
基金supported by the National High Level Hospital Clinical Research Funding,China(Grant Nos.:2022-PUMCH-A-204 and 2022-PUMCH-C-031)the National Natural Science Foundation of China(Grant No.:82274336).
文摘Adenomyosis is a common gynecological disease characterized by the invasion of endometrial glands and stroma into the myometrium of uterus,the pathological mechanism of which remains unclear yet.Disturbed lipid metabolism extensively affects abnormal cell proliferation and invasion in various diseases.However,the lipidome signature of human myometrium,which could be crucial in the development of adenomyosis,remains unknown.In this study,we generated the first lipidome profiling of human myometrium using a high-coverage and quantitative lipidomics approach based on ultraperformance liquid chromatography(UPLC)coupled with triple quadrupole(QqQ)-mass spectrometry(MS).A total of 317 lipid species were successfully quantified in the myometrial tissues from women with(n=38)or without(n=65)adenomyosis who underwent hysterectomy at Peking Union Medical College Hospital(Bejing,China).Up to 83 lipid species showed significant alternations in content between the two groups.These lipid aberrations involved multiple metabolic pathways,and emphasized inflammation,cell migration,and immune dysregulation upon adenomyosis.Moreover,receiver operating characteristic(ROC)curve analysis found that the combination of five lipid species could accurately distinguished the myometrial samples from women with and without adenomyosis with an area under the curve(AUC)of 0.906.Desorption electrospray ionization MS imaging(MSI)further underscored the heterogeneous distributions of these lipid markers in the adenomyosis lesion and adjacent myometrial tissue.Collectively,these results extremely improved our understanding on the molecular basis of adenomyosis,and could shed light on developing potential biomarkers and new therapeutic directions for adenomyosis.
文摘目的:根据世界卫生组织(World Health Organization,WHO)的分析报告,全球不孕症患病率呈逐年上升趋势。分析造影剂逆流子宫肌层的相关风险因素,对降低造影剂逆流的发生率及治疗女性不孕症具有重要的意义。目前,临床上缺乏预评估输卵管造影逆流子宫肌层的有效指标,判断标准主要依赖于医生经验和患者症状。本研究旨在运用四维超声子宫输卵管造影的影像学特征来评价造影剂逆流子宫肌层的危险因素,并构建诺模图(nomogram)风险预测模型,为临床不孕症的诊疗提供参考。方法:本研究回顾性分析2020年1月1日至2022年12月15日在湖南妇女儿童医院和中南大学湘雅三医院就诊的1274例行四维子宫输卵管超声造影(hysterosalpingo-contrast sonography,HyCoSy)手术检查的不孕症女性患者的影像学特征。将发生造影剂逆流子宫肌层的不孕症患者设为逆流组(n=234),未发生造影剂逆流子宫肌层的不孕症患者设为未逆流组(n=1040)。对研究的基线变量与造影剂逆流子宫肌层结局依次采用单因素Logistic分析和多因素Logistic分析,筛选出有统计学意义的变量构建nomogram预测模型。通过Bootstrap分析进行内部验证,重复抽样次数为500。结果:未逆流组与逆流组的年龄分别为(30.66±4.83)和(31.82±5.27)岁,差异有统计学意义(P=0.0011)。未逆流组的不孕症类型以原发性不孕为主(50.96%),逆流组则以继发性不孕为主(76.50%),且72.65%的患者存在妇科手术史,组间差异均有统计学意义(均P<0.001)。逆流组出现月经量异常和主观不适情况的患者比例高于未逆流组,而未逆流组则较逆流组使用造影剂更多,差异均有统计学意义(P=0.0016、P<0.001、P<0.001)。在影像学方面,未逆流组与逆流组在内膜厚度、输卵管管壁光滑程度和卵巢周围造影剂弥散程度等方面存在不同,表现为未逆流组内膜厚度更厚,输卵管管壁更光滑、更通畅。Nomogram预测模型的受试者操作特征曲线的曲线下面积(area under the curve,AUC)为0.854,提示预测性能较好。模型内部验证的决策曲线分析(decision curve analysis,DCA)的AUC为0.737,当患者发生造影剂逆流子宫肌层的阈值概率为0.05~0.95时,净收益最高达0.18;应用nomogram预测模型的净收益水平高于全干预和全不干预的附加效益,提示该模型具有较好的临床预测效能。结论:基于不孕症类型、内膜厚度、造影剂量和主观不适等影响因素构建的nomogram预测模型能够准确预测四维HyCoSy术后造影剂逆流子宫肌层的发生风险,有助于临床医生尽早采取预防措施,降低造影剂内渗发生率及其他并发症的发生率。
文摘目的探讨子宫腺肌症(adenomyosis,AM)患者子宫肌层平滑肌组织中缩宫素受体(oxytocin receptor,OTR)的表达水平与痛经程度的关联性。方法收集2013年9月-2014年8月在本院妇科因AM行全子宫切除手术的腺肌症患者50例为腺肌症组,同期因子宫肌瘤行全子宫切除的患者20例为对照组。应用免疫组化染色法(S-P法)检测20例正常子宫肌层、50例子宫腺肌症肌层平滑肌组织中的OTR表达情况。采用光学显微镜及Image Plus Pro 6.0图像分析系统测定OTR水平,并对其差异进行分析。结果 AM组子宫肌层平滑肌组织中OTR的表达高于对照组(62 370±34 758 vs 16 082±11 125,P<0.01),且表达强度随着痛经程度的加重而增加,差异均有统计学意义。结论 OTR在AM患者子宫肌层平滑肌组织中的表达与痛经程度呈正相关,推测患者痛经形式可能为宫缩痛,表明宫缩强度的增加参与了AM疼痛的发病机制。
