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
目的:探讨子宫肌层3层缝合对剖宫产术后憩室大小的影响及子宫切口憩室(CSD)形成的相关因素。方法:回顾性分析2022年4~11月于华东师范大学附属芜湖医院行剖宫产术的240例产妇的临床资料,根据子宫肌层缝合方式的不同分为3层缝合组(124例)...目的:探讨子宫肌层3层缝合对剖宫产术后憩室大小的影响及子宫切口憩室(CSD)形成的相关因素。方法:回顾性分析2022年4~11月于华东师范大学附属芜湖医院行剖宫产术的240例产妇的临床资料,根据子宫肌层缝合方式的不同分为3层缝合组(124例)和双层缝合组(116例);另根据术后是否形成CSD将产妇分为CSD组(23例)和非CSD组(217例)。对比3层缝合组与双层缝合组产妇的临床特点,采用多因素Logistic回归分析CSD形成的独立影响因素并构建人工神经网络模型;采用受试者工作特征(ROC)曲线、校准曲线和临床决策曲线进行模型验证。结果:①3层缝合组产妇的子宫肌层瘢痕厚度显著高于双层缝合组(7.06±2.09 mm vs.5.68±1.97 mm);而CSD形成情况(4.03%vs.15.52%)和憩室大小(0.36±0.09 ml vs.0.47±0.12 ml)则显著低于双层缝合组,差异均有统计学意义(P<0.05);②多因素分析示,子宫后屈、剖宫产次数≥2次、胎膜早破、围产期感染、剖宫产时机(择期)是影响CSD形成的独立危险因素(OR>1,P<0.05),而子宫肌层3层缝合是保护性因素(OR<1,P<0.05);③人工神经网络预测模型显示剖宫产次数、胎膜早破以及是否进行3层缝合所占权重均较高,经ROC曲线、校准曲线和临床决策曲线验证表明该模型预测能力良好。结论:CSD的形成与子宫后屈、剖宫产次数、胎膜早破、围产期感染、剖宫产时机等指标有关,临床应重点关注,此外,子宫肌层3层缝合可降低CSD的形成概率,在临床上值得推广应用。展开更多
Objective The latest perspective suggests that elevated levels of inflammation and cytokines are implicated in atonic postpartum hemorrhage.Lipopolysaccharide(LPS)has been widely used to induce inflammation in animal ...Objective The latest perspective suggests that elevated levels of inflammation and cytokines are implicated in atonic postpartum hemorrhage.Lipopolysaccharide(LPS)has been widely used to induce inflammation in animal models.Therefore,this study aimed to induce uterine inflammation using LPS to investigate whether local inflammation triggers dysfunction and atrophy in the myometrium,as well as the potential underlying molecular mechanisms involved.Methods In vivo,an animal model was established by intraperitoneal injection of 300μg/kg LPS in rats on gestational day 21.Hematoxylin-eosin(H&E)staining and Masson staining were employed to determine morphological changes in the rat uterine smooth muscle.Enzyme-linked immunosorbent assay(ELISA)was used to detect inflammatory cytokines.Immunohistochemistry,tissue fluorescence,and Western blotting were conducted to assess the expression levels of the uterine contraction-related proteins Toll-like receptor 4(TLR4)and the nuclear factor kappa-B(NF-κB)signaling pathway.In vitro,human uterine smooth muscle cells(HUtSMCs)were exposed to 2μg/mL LPS to further elucidate the involvement of the TLR4/NF-κB signaling pathway in LPS-mediated inflammation.Results In this study,LPS induced uterine myometrial dysfunction in rats,leading to a disorganized arrangement,a significant increase in collagen fiber deposition,and widespread infiltration of inflammatory cells.In both in vivo animal models and in vitro HUtSMCs,LPS elevated IL-6,IL-1β,and TNF-αlevels while concurrently suppressing the expression of connexin 43(Cx43)and oxytocin receptor(OXTR).Mechanistically,the LPS-treated group exhibited TLR4 activation,and the phosphorylation levels of p65 and IκBαwere notably increased.Conclusion LPS triggered the TLR4/NF-κB signaling pathway,inducing an inflammatory response in the myometrium and leading to uterine myometrial dysfunction and uterine atony.展开更多
Background: The myometrium at the location of the CS (caesarean section) scars, also known as residual myometrium thickness (RMT), is larger after a double-layer uterine closure procedure than following a single-layer...Background: The myometrium at the location of the CS (caesarean section) scars, also known as residual myometrium thickness (RMT), is larger after a double-layer uterine closure procedure than following a single-layer one. It may lessen the formation of a niche that is the myometrium’s disruption at the location of the scar of the uterus. Gynecological manifestations, obstetric problems in a future pregnancy and birth, and maybe subfertility are linked to thin RMT and a niche. Objective: To ascertain if double-layer unlocked closure of the uterus is better than single-layer one in terms of post-menstrual spotting and niche development following a first CS. Patients and Methods: In this randomized clinical study, 287 patients were evaluated for qualifying. Of all eligible individuals, 57 patients were excluded from the study based on the inclusion criteria. Results: The variation in ages, gestational age, body mass index (BMI), and cesarean section indications between the two assigned groups is statistically insignificant. However, postmenstrual spotting was statistically significantly more common in single-layer group compared to in double-group. The current study revealed ultrasound findings suggestive of niche formation was statistically significantly more common in single-layer group compared to in double-layer group. Conclusion: As evident from the current study, it demonstrates the advantages of double-layer unlocked closure of the uterus over single-layer one in terms of post-menstrual spotting and niche development following first-time cs. Thus, we deduced that fewer niches are formed, and fewer menstrual spotting occurs in the presence of double unlocked layers closure. To ascertain the impact of uterus closure method on post-operative niche development and the risk of obstetrics and gynaecological problems, further prospective trials with extended follow-up periods are required.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.
文摘目的:探讨子宫肌层3层缝合对剖宫产术后憩室大小的影响及子宫切口憩室(CSD)形成的相关因素。方法:回顾性分析2022年4~11月于华东师范大学附属芜湖医院行剖宫产术的240例产妇的临床资料,根据子宫肌层缝合方式的不同分为3层缝合组(124例)和双层缝合组(116例);另根据术后是否形成CSD将产妇分为CSD组(23例)和非CSD组(217例)。对比3层缝合组与双层缝合组产妇的临床特点,采用多因素Logistic回归分析CSD形成的独立影响因素并构建人工神经网络模型;采用受试者工作特征(ROC)曲线、校准曲线和临床决策曲线进行模型验证。结果:①3层缝合组产妇的子宫肌层瘢痕厚度显著高于双层缝合组(7.06±2.09 mm vs.5.68±1.97 mm);而CSD形成情况(4.03%vs.15.52%)和憩室大小(0.36±0.09 ml vs.0.47±0.12 ml)则显著低于双层缝合组,差异均有统计学意义(P<0.05);②多因素分析示,子宫后屈、剖宫产次数≥2次、胎膜早破、围产期感染、剖宫产时机(择期)是影响CSD形成的独立危险因素(OR>1,P<0.05),而子宫肌层3层缝合是保护性因素(OR<1,P<0.05);③人工神经网络预测模型显示剖宫产次数、胎膜早破以及是否进行3层缝合所占权重均较高,经ROC曲线、校准曲线和临床决策曲线验证表明该模型预测能力良好。结论:CSD的形成与子宫后屈、剖宫产次数、胎膜早破、围产期感染、剖宫产时机等指标有关,临床应重点关注,此外,子宫肌层3层缝合可降低CSD的形成概率,在临床上值得推广应用。
基金supported by the National Key Research and Development Program of China(No.2021YFC2701500).
文摘Objective The latest perspective suggests that elevated levels of inflammation and cytokines are implicated in atonic postpartum hemorrhage.Lipopolysaccharide(LPS)has been widely used to induce inflammation in animal models.Therefore,this study aimed to induce uterine inflammation using LPS to investigate whether local inflammation triggers dysfunction and atrophy in the myometrium,as well as the potential underlying molecular mechanisms involved.Methods In vivo,an animal model was established by intraperitoneal injection of 300μg/kg LPS in rats on gestational day 21.Hematoxylin-eosin(H&E)staining and Masson staining were employed to determine morphological changes in the rat uterine smooth muscle.Enzyme-linked immunosorbent assay(ELISA)was used to detect inflammatory cytokines.Immunohistochemistry,tissue fluorescence,and Western blotting were conducted to assess the expression levels of the uterine contraction-related proteins Toll-like receptor 4(TLR4)and the nuclear factor kappa-B(NF-κB)signaling pathway.In vitro,human uterine smooth muscle cells(HUtSMCs)were exposed to 2μg/mL LPS to further elucidate the involvement of the TLR4/NF-κB signaling pathway in LPS-mediated inflammation.Results In this study,LPS induced uterine myometrial dysfunction in rats,leading to a disorganized arrangement,a significant increase in collagen fiber deposition,and widespread infiltration of inflammatory cells.In both in vivo animal models and in vitro HUtSMCs,LPS elevated IL-6,IL-1β,and TNF-αlevels while concurrently suppressing the expression of connexin 43(Cx43)and oxytocin receptor(OXTR).Mechanistically,the LPS-treated group exhibited TLR4 activation,and the phosphorylation levels of p65 and IκBαwere notably increased.Conclusion LPS triggered the TLR4/NF-κB signaling pathway,inducing an inflammatory response in the myometrium and leading to uterine myometrial dysfunction and uterine atony.
文摘Background: The myometrium at the location of the CS (caesarean section) scars, also known as residual myometrium thickness (RMT), is larger after a double-layer uterine closure procedure than following a single-layer one. It may lessen the formation of a niche that is the myometrium’s disruption at the location of the scar of the uterus. Gynecological manifestations, obstetric problems in a future pregnancy and birth, and maybe subfertility are linked to thin RMT and a niche. Objective: To ascertain if double-layer unlocked closure of the uterus is better than single-layer one in terms of post-menstrual spotting and niche development following a first CS. Patients and Methods: In this randomized clinical study, 287 patients were evaluated for qualifying. Of all eligible individuals, 57 patients were excluded from the study based on the inclusion criteria. Results: The variation in ages, gestational age, body mass index (BMI), and cesarean section indications between the two assigned groups is statistically insignificant. However, postmenstrual spotting was statistically significantly more common in single-layer group compared to in double-group. The current study revealed ultrasound findings suggestive of niche formation was statistically significantly more common in single-layer group compared to in double-layer group. Conclusion: As evident from the current study, it demonstrates the advantages of double-layer unlocked closure of the uterus over single-layer one in terms of post-menstrual spotting and niche development following first-time cs. Thus, we deduced that fewer niches are formed, and fewer menstrual spotting occurs in the presence of double unlocked layers closure. To ascertain the impact of uterus closure method on post-operative niche development and the risk of obstetrics and gynaecological problems, further prospective trials with extended follow-up periods are required.
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。
