西方星占宫位制在中国古代的传播

自域外传入的天宫图星占学是中国古代星占学的重要组成部分,宫位制则是天宫图星占学的基础。本文系统考察了宫位制在不同历史时期的传播情况。研究发现,宫位制在中国主要经历了两期传入与本土化过程。第一期至迟从唐代开始,直到明末结束,是整宫制一枝独秀的时期。第二期发轫于明末清初欧洲星占学的传入,一直到清末,是雷格蒙塔努斯宫位制传播与整宫制继续使用的时期。

迷官·官迷·迷官

毕竟只有为数不多的同志在考虑进入梯队而且毕竟不是所有备考虑者都那么迷官,象官迷们用迷官的眼睛所看所想的那样。(点为笔者所加) ——王蒙《高原的风》(《人民文学》85,1) 在这句话中,“迷官”、“官迷”、“迷宫’三个词语,用得新颖、巧妙,乍读有趣,细品则更耐人咀嚼。 两个“迷官”和一个“官迷”,表面上同素反序,其实不是一个级别上的语言语单位。在两个“迷官”中,“迷”都是动词,“官”部是名词,二者构成的都是动宾词组,“官迷”则是名词,意为酷爱官位、达到入迷程度的人;从内部构成看,“官”是表示基本意义的词根,“迷”是表示附加意义的词缀,二者构成的是附加式合成词,其中,“迷”很值得研究,它由动词虚化而成,作为后缀,正显示出很强的构词能力。

An Investigation of the Potential Malignant Characteristics of Endometriosis

OBJECTIVE To investigate the potential malignant characteristics and pathogenesis of endometriosis as well as the role of human growth hormone and epidermal growth factor receptor in the pathogenesis of malignant transformation of endometriosis. METHODS The immunohistochemical S-P method was used to examine the expression of human growth hormone and epidermal growth factor receptor in the eutopic and ectopic endometrium of 84 cases of endometriosis. RESULTS The percentage of positive cases of human growth hormone in eutopic and ectopic endometrium was 90.77% （59/65） and 85.71% （72/ 84） respectively. The percentage of positive cases of epidermal growth factor receptor in eutopic and ectopic endometrium was 81.54% （53/65） and 89.29% （75/84） respectively. The positive rate of epidermal growth factor receptor in ectopic endometrium was higher than that in the eutopic endometrium but without a statistically significant difference （P〉 0.05）. CONCLUSION Endometriosis is caused by multiple factors, which possesses some biologic features of neoplastic tissue such as invasion and metastasis. Both human growth hormone and epidermal growth factor receptor are highly expressed in eutopic and ectopic endometrium, which lead directly or indirectly to the pathogenesis of endometriosis and promote the initiation and malignant transformation of endometriosis.

Sigmoid colon endometriosis treated with laparoscopy-assisted sigmoidectomy:Significance of preoperative diagnosis

We present a female patient with sigmoid colon endometriosis who was diagnosed correctly preoperatively and underwent minimally invasive surgery. She was admitted to our hospital with rectal bleeding and constipation. We performed several workups. Colonoscopy and endoscopic ultrasonography showed sigmoid colon stenosis caused by submucosal tumor, and magnetic resonance imaging revealed a sigmoid colon tumor displaying signal hy- pointensity on both T1- and T2-weighted imaging. However, colonoscopic ultrasonography-assisted needle aspiration biopsy could not specify tumor characteristics. From these examinations, the lesion was diagnosed as sigmoid colon endometriosis and laparoscopy-assisted sigmoidectomy was performed. Pathological diagnosis from the resected specimen was identical to preoperative diagnosis, i.e., colonic endometriosis. Since differential diagnosis of intestinal endometriosis seems difficult, a cautious preoperative diagnosis is required to select treatments including minimally invasive surgery.

MANAGEMENT OF URETERAL ENDOMETRIOSIS: A REPORT OF TEN CASES

Objective To investigate the clinical features and management of ureteral endometriosis. Methods Patients surgically and histologically diagnosed as ureteral endometriosis from January 2001 to January 2007 in Peking Union Medical College Hospital were retrospectively reviewed. Results Ten patients were diagnosed as ureteral endometriosis among 7 561 cases with surgically and histologically proved diagnosis of endometriosis, with an incidence of 0.132%. Nine out of 10 patients were extrinsic ureteral endometriosis and concomitant with severe pelvic endometriosis, and the other was intrinsic ureteral endometriosis. Hormone therapy failed in 2 patients with urinary tract obstruction. Ureterolysis was performed in 6 patients and ureterectomy was performed in 4 patients. One case of ureteral recurrence was observed in a postmenopausal woman without hormonal replacement therapy who received laparoscopic ureterolysis and hysterectomy with bilateral adnexectomy. No relapse was observed in the other 9 patients. Conclusions Ureteral endometriosis is a rare entity. The upper urinary tract should be evaluated in patients with severe endometriosis, even in postmenopausal women. The treatment of ureteral endometriosis usually requires surgery, while ureterolysis should not be performed in patients with extensive disease. As a form of adjuvant therapy of surgery, hormonal therapy is an appropriate option.

SERUM SOLUBLE E—CADHERIN LEVEL IN PATIENTS WITH ENDOMETRIOSIS

Objective.To investigate the serum sE cadherin level in patients with endometriosis and the alterations of that level in healthy control during the menstrual cycle.Methods.Thirty two patients with endometriosis and 30 healthy women were tested for serum sE cadherin levels by enzyme linked immunosorbent assay.Results.The serum sE cadherin levels in healthy control did not vary throughout the menstrual cycle,which were lower than those in patients with endometriosis.Conclusions.E cadherin might be involved in endometrial shedding during menstruation in endometriosis patients.The serum sE cadherin assay might be helpful as a serum marker for the diagnosis and management of endometriosis.

Gallbladder endometriosis as a cause of occult bleeding

A 17-year-old girl with colicky abdominal pain andchronic anemia presented to the gastrointestinal serviceof the University Hospital of Essen. In the routineworkup, there were no pathological findings despitethe anemia. Because of the fluctuation of symptomswith a climax at the time of menstruation, consecutiveultrasound studies were performed revealing a visiblemass inside the gallbladder. This finding was confirmedby a magnetic resonance imaging (MRI) study performedat the same time. Because of the severe anemia by thattime, a cholecystectomy was performed, and histologyreconfirmed the diagnosis of isolated gallbladderendometriosis. The patient recovered well and has hadno recurrence of the disease to date.

Intestinal endometriosis-A rare cause of colonic perforation

Endometriosis is the ectopic growth of viable endometrium outside the uterus, affecting approximately 7% of females. It commonly affects pelvic structures including the bowel. Perforation of the colon by endometriosis is very rare and the patients generally present with an asymptomatic or painful pelvic mass, often in the left iliac fossa. Our patient presented acutely unwell and her symptoms were more suggestive of pyelonephritis or diverticulitis. We therefore report an unusual cause of acute abdomen. The purpose of the following case report is to elucidate certain diagnostic and therapeutic problems of the disease, concerning both surgeons and gynaecologists. In summary, intestinal endometriosis should be considered in the differential diagnosis of all post-menarche women with episodic gastrointestinal symptoms. A past history of endometriosis or co-existent gynaecological symptoms should increase the index of suspicion, and taparoscopy prior to formal laparotomy should be considered. Our patient, in retrospect, had a history of mild endometriosis, but we feel that this case serves as a reminder of a rare, but important, differential diagnosis of acute abdomen in females.

Crohn’s disease complicated by multiple stenoses and internal fistulas clinically mimicking small bowel endometriosis

We report a 31-year-old woman with Crohn's disease complicated by multiple stenoses and internal fistulas clinically misdiagnosed as small bowell endometriosis, due to the patient's perimenstrual symptoms of mechanical subileus for 3 years; at first monthly, but later continuous, and gradually increasing in severity. We performed an exploratory laparotomy for small bowel obstruction, and found multiple ileal strictures and internal enteric fistulas. Because intraoperative findings were thought to indicate Crohn's disease, a right hemicolectomy and partial distal ileum resection were performed for obstructive Crohn's ileitis. Histopathology of the resected specimen revealed Crohn's disease without endometrial tissue. The patient made an uneventful recovery from this procedure and was discharged home 10 d post-operatively. The differential diagnosis of Crohn's diease with intestinal endometriosis may be difficult pre-operatively. The two entities share many overlapping clinical, radiological and pathological features. Nevertheless, when it is difficult to identify the cause of intestinal obstruction in a woman of child-bearing age with cyclical symptoms suggestive of small bowel endometriosis, Crohn's disease should be included in the differential diagnosis.

CHANGES OF SOLUBLE FAS AND SOLUBLE FAS LIGANDIN SERUM AND PERITONEAL FLUID OF INFERTILEPATIENTS WITH ENDOMETRIOSIS

Objective To evaluate the relationship between levels of soluble Fas(sFas)and soluble Fas ligand(sFasL)in serum and peritoneal fluid of endometriosis-associated infertility. Methods The soluble Fas ligand and soluble Fas levels in serum and peritoneal fluid of 20 infertile patients with endometriosis were assessed with enzyme-linked immunosorbent assay, and were compared with 14 infertile patients due to chronic pelvic infectious disease and 16 fertile controls. Results The sFasL levels were significantly higher in infertile patients with endometriosis(175.09 ± 80.55 pg/mL in serum and 284.50 ± 152.38 pg/mL in peritoneal fluid)than those of infertile controls (88.47 ± 43.55 pg/mL in serum and 17.30 ± 9.62 pg/mL in peritoneal fluid)and fertile controls(16.13 ± 11.75 pg/mL in serum and 8.84 ± 2.31 pg/mL in peritoneal fluid). In contrast, as for the sFas levels, infertile patients with endometriosis(828.60 ± 429.65 pg/mL in serum and 349.61 ± 288.89 pg/mL in peritoneal fluid)did not show any significant difference compared with those in infertile patients resulting from pelvic infectious disease(868.75 ± 570.48 pg/mL in serum and 181.76 ± 157.78 pg/mL in peritoneal fluid)and fertile control(822.26 ± 129.12 pg/mL in serum and 318.42 ± 145.16 pg/mL in peritoneal fluid). Conclusions Based upon these results, high level of sFasL in serum and peritoneal fluid and thus apoptosis mediated by it may be implicated in the mechanism involved in endometriosis-related infertility.

ABDOMINAL SCAR ENDOMETRIOSIS:REPORT OF 28 CASES

Twenty-eight cases of abdominal scar endometriosis from Janurary, 1980 to December, 1993 are reported. Of these patients, twenty-four underwent term cesarean section, and four underwent a midtrimester abortion by abdominal hysterotomy, The majority of patients manifested symptoms 1 year after the operation. The most common was a painful mass of scar tissue that became swollen and tender during menstruation. The pathogenesis, diagnosis and treatment are discussed. In correlation with the pathological findings, the effects of drug therapy are evaluated. It was found that surgical excision is the best method of treatment.

A CASE-CONTROL EPIDEMIOLOGIC STUDY OF ENDOMETRIOSIS

A case-control study involving 203 cases of pelvic endometriosis seen from 1987- 1989 , and 406 randomly selected and age-matched community controls was conducted in order to provide information relevant to effective prophylxais of the disease. The diagnosis was confirmed by pathology from laparotomy and/or laparoscopy. A questionnaire focused on menstrual, marital and reproductive status , professional exposure and physical activities ,and the results were analyzed by a conditional logistic regression model. Women characterized by earlier menarche(≤ 12 years) and longer period(≥8 days) were found to be associated with an elevated incurring risk, and a trend of increasing risk associated with primary dysmenorrhea (RR =2. 1 for mild to moderate and RR= 5. 2 for severe dysmenorrhea), energetic physical activity during menstruation (RR =2. 1) , and allergic diathesis(RR=1 . 8) was seen. An inverse relationship was observed between the number of pregnancies and risk of endometriosis,and the protective effect was most significant when only the number of full-term pregnancies was counted.The risk factors of endometriosis are discussed, and intensive treatment of primary dysmenorrhea and avoidance of strenuous exercise during menstruation are identified as important measures in the prevention of endometriosis.

Atypical Endometriosis:a Clinicopathologic Study of 163 Cases

OBJECTIVE To investigate the clinicopathologic features of atypical endometriosis （AEM）, and to discuss the relations between AEMs and tumors. METHODS A retrospective analysis was performed on 163 cases of AEMs. The changes in the glandular epithelium, stroma, and their background and the relationship with coexisting tumors were observed. RESULTS The AEMs account of for 4.4% （163/3,724） of the endometriosis （EM） cases. Of 172 AEM foci of 163 patients, 168 were in the ovary, and the other 4 were in the fallopian tube, cervix and uterine serosa. Of the cases of ovarian EM, 6.8% were AEM. All of the 27 cases （15.7%） of the AEMs associated with a tumor were found in the ovaries, of which 15 were malignant, 9 borderline, and 3 benign. Of the ovary AEMs, 14.9% were associated with a borderline or malignant tumor. The AEM epithelia were mainly arranged in the form of surface epithelia, with only a few glands. Present were characteristic features of moderate to marked pleomorphism, epithelial tufting, bud or firework-like structures on microscopy. Epithelial metaplastic changes were observed in 86 cases （50%） of the 172 AEM foci. Epithelium, endometrioid stroma, and fibrotic-collagen formed a three-layer structure in the wall of the AEM cysts. The endometrioid stroma were usually thin compared to the fibro-collagen tissue. The transformation from an AEM to a tumor was found in most of the malignant tumors. CONCLUSION AEM lesions have some features which are similar and also differ from both of the tumor and EM. AEMs have a relative higher potential for tumorigenesis and canceration, especially for ovarian cancer. The process of damage, repair, and scarring in EM foci over a long period may play a role in the development of EM into AEM and eventally into tumor formation.

TREATMENT OF 70 CASES OF ACUTE GASTROENTERITIS WITH ELECTROACUPUNCTURE OF MAIN ACUPOINT NEIGUAN AND GONGSUN

Objective: To observe clinical therapeutic effect of electro-acupuncture (EA) of Neiguan (PC 6), Gongsun (SP 4), etc. in the treatment of acute gastroenteritis. Methods: A total of acute gastroenteritis patients observed were randomized into two groups, i.e. 70 cases in the treatment group receiving EA of main acupoint Neiguan (PC 6) and Gongsun (SP 4) and acupuncture of supplementary acupoint Guanyuan (CV 4), Zusanli (ST 36), Pishu (BL 20) and 50 cases in the control group treated by oral administration of Norfloxacin capsules. Results: Statistically, the therapeutic results of the 2 groups were not significantly different (P>0.05), showing that EA of Neiguan (PC 6) and Gongsun (SP 4) is an effective therapeutic method for acute gastroenteritis.

Immunohistochemical characterization of β-catenin in gynecologic tumor and its diagnostic value

β-catenin is a very unusual protein with multiple functions depending on its cellular localization. The β-catenin gene (CTNNB1) encodes for β-catenin and apart from its well-defined role in cellular adhesion,it is also a component of the Wnt signalling pathway. The Wnt/β-catenin pathway is involved in various normal cellular activities,including determination,proliferation,migration and differentiation in embryonic development and adult homeostasis. Deregulation or constitutive activation of the Wnt/β-catenin pathway may lead to cancer formation. Immunohistochemical expression of β-catenin in gynecologic tumor have been reported recently. In normal epithelia,immunoreactivity was strongly observed at the membrane,partially at cytoplasm,nuclear staining of β-catenin was rarely seen in normal cases; In ovarian carcinomas,β-catenin nuclear expression was found more commonly in endometrioid carcinomas,nuclear β-catenin staining seemed to be of prognostic importance; In endometrium carcinomas,β-catenin nuclear expression were more common in pure endometrioid tumors than in unendometrioid tumors,associated with favorable prognosis,the staining pattern was independent of the menopausal status; In synchronous primary cancers of the endometrium and ovary,activating mutations in β-catenin seemed to distinguish synchronous primary tumors from metastatic tumors.

“高宫”律位

自古至今 ,“燕乐”理论家皆谓“高宫”律位在雅乐大吕(俗律 [夹钟 ]) ,本文作者以为有误。本文作者从“二十八调在竹”、从《碧鸡漫志》、宋人词作、“北曲”传唱谱等实例 ,证说本管“高宫”律位在俗律 [姑洗 ](雅律太簇) ;并以唐白居易诗作、《乐府杂录》、宋姜白石之作品等实例 ,证说以雅乐大吕(俗律 [夹钟 ])为宫位之“高宫”系用比本管高一律之“银字管”吹出者。

Complication of cesarean section: pregnancy on the cicatrix of a previous cesarean section

OBJECTIVE: To probe into the clinical manifestation, diagnosis, as well as treatment of pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester. METHODS: Analysis of 14 patients with pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester was made after conservative treatment by drugs from January 1996 to December 1999. RESULTS: The 14 patients with a pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester were painless, had slight vaginal bleeding, and concurrently had increased serum beta-subunit human chorionic gonadotropin (beta-HCG). Doppler ultrasonic examination revealed an obvious enlargement of the previous cesarean section cicatrix in the uterine isthmus, and found a gestational sac or mixed mass attached to the cicatrice, with a very thin myometrium between the gestational sac and bladder walls. Among the 14 patients, 12 patients had crystalline trichosanthes injected into the cervix, mifepristone taken orally, or methotrexate in the form of intramuscular injection. Following this procedure, their serum beta-HCG dropped to normal. The other 2 patients had a total hysterectomy. CONCLUSIONS: Pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester is a complication of cesarean section. Early diagnosis and effective conservative treatment by drugs are instrumental in decreasing the potential occurrence of uterine rupture, which is also conducive to preserving the patient's future fertility.

Effect of recombinant human endostatin on endometriosis in mice

Background Direct and indirect evidences have suggested that angiogenesis is a prerequisite for the development of endometriosis. Aiming at offering experimental evidences for anti-angiogenesis therapy, we transplanted the eutopic endometrium from patient with endometriosis into the severe combined immunodeficiency disease （SCID） mice, to evaluate the effect of the endostatin on the growth and angiogenesis of the established endometriosis lesions in SCID mice model. Methods Eutopic endometrium of women with endometriosis was transplanted into the SCID mice. The mice were randomized into treatment （n= 10） and control groups （n=10）. Two weeks after the implantation of endometrium fragment, the treatment group was injected with recombinant human endostatin YH-16 into the peritoneal cavity （2 mg·kg^-1·d^-1）, whereas the control group received equivalent volume of PBS （200 μl/d）. The volume of endometriotic lesions in SCID mice was measured every three days, and all the treatment lasted for 14 days. Immunohistochemistry was used to determine microvessel density （MVD） and the expression of VEGF. The results were analyzed by t test and X^2 test to value the treating effect. Results Compared with the control group, growth of endometriosis lesion was reduced in the mice treated with YH-16. Statistically significant differences in the volume and weight of the ectopic lesions were observed between the treatment and the control groups （P〈0.05）. Microscopical examination showed that after being treated with YH-16, the volume of the endometrial tissues decreased, the glands depauperated, and the glandular epithelium partially degenerated. Necrotic debris was observed in the endometrial stroma. MVD and expression of VEGF in the treatment group were significantly lower than those in the control group （P〈0.05）.Conclusions Recombinant human endostatin affects the maintenance and growth of endometriotic tissues by inhibiting angiogenesis and reducing the expression of VEGF in ectopic lesion. The angiostatic agent may be promising as a therapy for endometriosis.

Effect of Bushenwenyanghuayu decoction on nerve growth factor and bradykinin/bradykinin B_1 receptor in a endometriosis dysmenorrhea mouse model

OBJECTIVE:To observe the effects of Bushenwenyanghuayu decoction(BD),a Traditional Chinese Medicine(TCM),on the serum concentration of nerve growth factor(NGF) and bradykinin(BK),and protein and mRNA levels of NGF and bradykinin B_1receptor(BKB1R) in a mouse model of endometriosis dysmenorrhea.METHODS:Seventy-five experimental female BALB/c mice were randomly divided into five groups,15 mice each:sham,model,BD high dose(61.67 g/kg),BD low dose(15.42 g/kg),and gestrinone(0.4 mg/kg) groups.All the mice except for those in the sham group underwent auto-transplantation surgery and were gavaged estradiol valerate(0.5 mg/kg,daily for 12 days) after surgery.On the 12 th day,1 h after administration,writhing response was induced by intraperitoneal injection of oxytocin at 2 U/mouse.The writhing frequency and latency were recorded and the volume of the ectopic foci was measured.The concentration of serum NGF and BK was detected by enzyme-linked immunosorbent assay,the protein expression of NGF and BKB1 R was tested by immunohistochemistry and western blotting,and NGF and BKB1 R mRNAs were detected by real-time PCR.RESULTS:Compared with the model group,the volume of the ectopic foci in the treatment groups was significantly lower(P < 0.01),the writhing frequency was decreased(P < 0.05),and the writhing latency was prolonged(P < 0.01).Compared with the sham group,serum NGF and BK levels in the model group were significantly increased(P <0.01).There were positive correlations for writhing frequency among the NGF and BK groups(P <0.01).The serum NGF and BK levels were significantly lower in the treatment groups than the model group(P < 0.05).The protein expression of NGF,BKB1 R was significantly decreased in the treatment groups compared with the model group(P < 0.01).NGF and BKB1 R mRNA expression was significantly decreased in the treatment groups compared with the model group(P < 0.01).CONCLUSION:NGF and BK/BKB1 R may play an important role in the development of endometriosis-associated dysmenorrhea,and BD was found to inhibit the development of endometriosis and relieve dysmenorrhea by influencing NGF and BK/BKB1 R mRNA and protein levels.

Clinical Observation on Treatment of Endometriosis with Acupuncture plus Herbs

Objective： To compare the clinical efficacy of combined acupuncture and herbs with danazol in treating endometriosis. Methods： Seventy-eight patients were randomly divided into a combined acupuncture and herbs group （n= 40） and a Western medicine control group （n= 38）. Observation was made on changes in clinical symptoms, signs, serum CA125,β-EP, PGE2 and PGF2α, and adverse reaction to the medicine in the two groups. Results： The overall efficacy was similar in the two groups, but the effects on lumbosacral pain, anal downbearing distention, irregular menstruation and infertility were significantly better in the treatment group than in the control group （P（0.05）, and in the treatment group serum CA125, PGE2 and PGF2α were significantly lower and serum β-EP was significantly higher after treatment than before （P（0.05）. Conclusion： Combined use of acupuncture and herbs has a marked effect on endometriosis and the adverse reaction is lower than the control group.