子痫前期患者胎盘组织中MKP-1的表达及意义

目的:探讨MAPK磷酸酯酶-1(MKP-1)在子痫前期患者胎盘组织中的表达及意义。方法:采用免疫组织化学方法检测60例子痫前期患者及30例正常妊娠妇女胎盘组织中MKP-1的表达。结果:正常妊娠组及轻、重度子痫前期组胎盘组织中MKP-1表达逐渐减弱,各组间差异具有统计学意义(P<0.05)。结论:子痫前期患者胎盘中MKP-1表达水平的变化导致胎盘滋养细胞凋亡与子痫前期的发病及病情发展有关。

THE ROLE OF HYSTERECTOMY IN THE THERAPY OF GESTATIONAL TROPHOBLASTIC TUMOR

To evaluate the role of hysterectomy for patients with gestational trophoblastic tumor. [WT5”BX]Methods.[WT5”BZ]We retrospectively analyzed 68 cases of gestational trophoblastic neoplasia treated by hysterectomy from 1985～1997 at PUMC hospital. Thirty eight cases were diagnosed of choriocarcinoma and 30 were invasive mole. [WT5”BX]Results.[WT5”BZ]Twenty three elder patients who didn’t desire to preserve fertility were selected for hysterectomy after shorter courses of chemotherapy, 22 of them had a complete remission(95 6%), the total aver age courses of chemotherapy was 4 2. Of twenty seven chemorefractory cases who were suspected of a refractory isolated lesion in the uterus, delayed hysterectomy as an adjunct to chemotherapy was performed, 20 of them got a complete remission(74 1%), the total average courses of chemotherapy were 9 4. Emergency hysterectomy is indicated in 18 patients with uterine perforation or life threatening hemorrhage, 17 cases had a complete remission(94 4%), the total average courses of chemotherapy were 7 6. [WT5”BX]Conclusion.[WT5”BZ]Although the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, hysterectomy remains an important adjuncts in the treatment of a selected subset of patients; in order to operate more completely and prevent recurrence, it’s better to perform extended hysterectomy for the indicated patients.

A COMPARATIVE STUDY OF TRANSVAGINAL ULTRASONOGRAPHY AND PELVIC ARTERIOGRAM IN ASSESSMENT OF PATIENTS WITH GESTATIONAL TROPHOBLASTIC TUMOUR

Objective:To compare the reliability of transvaginal ultrasonography with pelvic arteriography in the assessment of patients with gestational trophoblastic disease. Methods. Transvaginal ultrasonography was performed in 24 patients with gestational trophoblastic tumour. Within one week after ultrasound investigation, pelvic arteriography was carried out in each patient. Of 24 cases, 16 patients hadn’t been treated by chemical reagent, 5 had accepted 2 to 5 courses of chemotherapy, and 3 had achieved complete remission before both investigations performed. Results. In 3 patients with complete remission, 2 had no evidence of abnormal findings either on transvaginal ultrasonography or on pelvic arteriography, 1 showed intramyometrial lesions by both methods. In the remaining 21 patients, all demostrated a abnormal uterine image, and 5 of them accompanied with the finding of parametrium metastatic signs by transvaginal ultrasonography; these abnormal results were confirmed by pelvic arteriographic imaging. However, in two cases without clinical and ultrasonic signs of parametrium metastasis, pelvic arteriography indicated the early metastasis of parametrium ves- sels. Conclusions. Even though it is difficult to predict the early parametrium metastasis in patients with gestational trophoblastic disease by B-ultrasonic investigation, our data would support the introduction of transvaginal ultrasonography in the diagnosis and evaluation of gestational trophoblastic tumour.

Spontaneous hemoperitoneum from hepatic metastatic trophoblastic tumor

Spontaneous hemoperitoneum(SP) is defined as the presence of blood within the peritoneal cavity that is unrelated to trauma.Although there is a vast array of etiologies for SP,primary hepatocellular carcinoma and hepatic adenoma are considered to be the most common causes.Hepatic metastatic tumor associated with spontaneous rupture is rare.SP from hepatic metastatic trophoblastic tumor may initially present with a sudden onset of abdominal pain.Abdominal computed tomography(CT) plays an important role in establishing the diagnosis of SP,indicating its origin and etiology,and determining subsequent management.Herein,we report an uncommon case of hemoperitoneum from spontaneous rupture of a hepatic metastatic trophoblastic tumor in a young female patient.Interestingly,the contrast-enhanced CT findings demonstrated hypervascular hepatic masses with persistent enhancement at all phases,which were completely different from the common appearances of hepatic metastases.For SP resulting from hepatic metastatic tumors,surgical intervention is still the predominant therapeutic method,but the prognosis is very poor.

Angiogenesis at Different Stage of Pregnancy Ingoatplacenta

The increase intransplacental exchange depends primarily on the great development of the placental vascular bed. The aim of this study was to evaluate the pattern of placental vascular development at day 50 and 100 of pregnancyin goats and the relationship with the vascular endothelial growth factor （VEGF） immunolocalization. The placental morphometric variables： capillary area density, capillary perimeter density, capillary number density and average capillary perimeter of the caruncular （CAR） and cotyledonary （COT） tissues were measured at day 50 （n = 5） and 100 （n = 5） of gestation. Also, the immunolocalization of VEGF was performed. In the CAR and COT tissues a significant increase of capillary area density and capillary perimeter density at day 100 of the gestation was observed. In the COT tissue, this was due to the increase in the capillary number density; however in the CAR tissue this was due to the increase in the capillary size. We can conclude that in both tissues there were different strategies to increase the capillary area and, thereby, the nutrients exchange. The immunolocalization of VEGF in the COT tissue showed the endothelial cells of blood vessels and trophoblastcells surrounding the villi intensely inmunostained, which would indicate the involvement of VEGF in the placental vascular development.

Distribution and characteristics of telocytes as nurse cells in the architectural organization of engineered heart tissues

Interstitial Cajal-like cells are a distinct type of interstitial cell with a wide distribution in mammalian organs and tissues,and have been given the name"telocytes".Recent studies have demonstrated the potential roles of telocytes in heart development,renewal,and repair.However,further research on the functions of telocytes is limited by the complicated in vivo environment.This study was designed to construct engineered heart tissue(EHT)as a three-dimensional model in vitro to better understand the role of telocytes in the architectural organization of the myocardium.EHTs were constructed by seeding neonatal cardiomyocytes in collagen/Matrigel scaffolds followed by culture under persistent static stretch.Telocytes in EHTs were identified by histology,toluidine blue staining,immunofluorescence,and transmission electron microscopy.The results from histology and toluidine blue staining demonstrated widespread putative telocytes with compact toluidine blue-stained nuclei,which were located around cardiomyocytes.Prolongations from the cell bodies showed a characteristic dichotomous branching pattern and formed networks in EHTs.Immunofluorescence revealed positive staining of telocytes for CD34 and vimentin with typical moniliform prolongations.A series of electron microscopy images further showed that typical telocytes embraced the cardiomyocytes with their long prolongations and exhibited a marked appearance of nursing cardiomyocytes during the construction of EHTs.This finding highlights the great importance of telocytes in the architectural organization of EHTs.It also suggests that EHT is an appropriate physical and pathological model system in vitro to study the roles of telocytes during heart development and regeneration.

Epithelioid trophoblastic tumor of the uterus:a report of three cases

Epithelioid trophoblastic tumor （ETT） of the uterus is a rare tumor introduced recently, which is distinct from placental site trophoblastic tumor （PSTT） and choriocarcinoma with the histological appearance of resembling low-grade squamous cell carcinomas. Definition and treatment of this disease is still not very clear because of its very low incidence and epithelioid trophoblastic lesions. ETT generally behaves in a benign fashion with metastatic and death rates about 25% and 10%, respectively, Here we report three cases of ETT, in which one had metastasis and eventually died from the disease.