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Objective To study the changes of six sex hormones corresponding to the follicle growth during the normal menstrual cycle of Chinese women.Methods Thirty Chinese women with regular menstrual period and average age of (28.8±3.2) years were selected for the study by Peking Union Medical College Hospital in September,2010.Growth of follicles was monitored by using transvaginal sonography.Six sex hormones,including follicle-stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E2),progesterone (P),testosterone (T),and prolactin (PRL) were measured by chemoluminescence immunoassay every day during a menstrual cycle.Nonparametric statistical analysis was used.ResultsMenstrual cycle of all the patients was in the range of 25 to 39 d,with mean of (29.5 ± 3.1) d.Length of follicular phase and luteal phase was 15.3 and 14.4 d,respectively.Number of days from antral follicle to emergence of dominant follicle,and from the latter to ovulation,was 6.2 and 8.9 d,respectively.Average diameter of preovulatory follicle was 19.33 mm.Both FSH and LH reached peak on the day before ovulation.P started to increase before ovulation and remained at a high plateau from 6th to 9th day after ovulation.Both PRL and T reached peak after ovulation,near the end of a menstrual cycle.Conclusions A small rise of LH and P emerges just 1 to 2 d before ovulation,indicating the maturing of follicle.PRL and T shows cyclic changes as follicle grows.Therefore,PRL and T levels should be measured in the early follicle phases in the clinical practice so that leading the impact of menstrual cycle minimal.
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Objective To investigate efficient diagnosis and treatment of 17α-hydroxylase (17OHD) deficiency by summarizing clinical characteristics of those patients.Methods From January 1983 to January 2010,48 cases with 17OHD in Peking Union Medical College Hospital were studied retrospectively.Results Among 48 patients with 17OHD,karyotype analysis showed,12 cases with 46,XX and 36 cases with 46,XY.The 46,XX karyotype and 46,XY karyotype with complete 17OHD had typical clinical presentation of amenorrhea [ 12/12,100％ ( 36/36 ) ],no typical spontaneous puberty [ 12/12,13.9％ (5/36) ],Hypertension [ 11/12,100％ ( 36/36 ) ],hypokalemia [ K +:( 2.6 ± 0.7 ),( 2.8 ± 0.7 )mmol/L],hypergonadotropin [ follicle-stimulatinghormone ( FSH ):( 51 ± 35 ),( 79 ± 46 ) U/L,luteinizing hormone( LH ):( 27 ± 14 ),(49 ± 37 ) U/L ],impaired production of sex hormones [ testosterone(T):0.003,0.005 nmol/L; estradiol ( E2 ):26.86,10.64 pmol/L ],hyper-progesterone [ (P):( 32 ± 15 ),( 29 ± 23) nmol/L],impaired production of 17α-hydroxyprogesterone ( 17α-OHP ) [ ( 2.5 ± 1.1 ),( 2.4 ±1.7) nmol/L],ACTH hypersecreation (91.8,114.0 pmol/L).ACTH stimulating test did not elevated in 17α-OHP and cortisol.Conclusion When patients with elevated basal serum levels of progesterone higher than that of ovulation period in addition to clinical symptoms,examination about 17OHD should be warranted.
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Objective To characterize hypersensitivity reactions to chemotherapy with carboplatin in patients with gynecologic malignancies and serve use of carboplatin.Methods We retrospectively analyzed the clinical features,management,or outcome of carboplatin-related hypersensitivity reactions in 13 patients with gynecologic malignancies from 1983 to 2008.Results Twenty times hypersensitivity reactions happened in thirteen women with carboplatin hypersensitivity reactions.The earliest one was at the 5th cycle,the last one was at the 28th cycle;the average cycle was 11.6.The accumulative dosage of carboplatin was 1 900-11 400 mg.The average dose was 4840 mg,2500-7200 mg were the main dose range.More than 5 cycles and (or) more than 2500-7200 mg of carboplatin administration significantly increased the incidence of hypersensitivity reactions in the twelve patients.Beactions were generally occurred at the first 5-10 minutes during intravenous infusion.The average time was 7.6 minutes.Symptoms included mild-to-moderate reactions and severe reactions.Thirteen patients experienced earboplatin hypersensitivity.Two out of 13 cases exhibited severe hypersensitivity reaction at the first time.The first hypersensitivity reactions was mild-to-moderate in 11 cases.When retreated with carboplatin,4 exhibited no more reactions,5 exhibited mild-to-moderate hypersensitiviry reactions,2 exhibited severe reactions.Mildto-moderate reactions were resolved by temporary interruption of carboplatin infusion,and (or) using steroid,while severe hypersensitivity reactions were resolved by more medicines.Conclusions The hypersensitivity reactions in the patients receiving carboplatin are increased after multiple doses of the agent.The possible of retreat with the carboplatin for the mild-to-moderate reactions may be considered.Hypersensitivity reactions should be treated actively.The following chemotherapy should be planed individually.The primary chemotherapy protocol for the patients with severe hypersensitivity reactions should not be reconsidered.
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Objective To study the clinical characteristic, the optimal treatments and the prognosis for the recurrence and failure of primary treatment in malignant ovarian germ cell tumors (MOGCT).Methods The clinical data of 17 recurrent and failure of primary treatment in MOGCT cases treated in Pecking Union Medical College Hospital from January 1983 to May 2008 were analyzed retrospectively to evaluate failure of primary treatment and second treatment. Results Only the 4 eases of recurrent and failure of primary treatment of MOGCT were underwent comprehensive surgical staging. After primary surgery in 1 -8 months, 16 cases received the non-standard chemotherapy were found the lesion again. The secondary debulking surgery was done for the 15 cases and also received the standard chemotherapy. Among of them, 8 cases were survival during follow up, 5 cases gave up the treatment and 4 patients were lost following up during the treatment. Conclusions The standard primary treatment is the most important for the MOGCT. Even for the recurrence and failure of primary treatment of MOGCT, the satisfied cytoreduetive surgery plus the standard chemotherapy also show the significant impact on the prognosis.
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Objective To establish the nude mouse model for in vivo research on endometriosis.So to study the mechanism and effect of anti-vascular endothelial growth factor(VEGF) antibody treatment on the growth of established endometriotic-like lesions in the nude mouse model.Methods Human endometrium is implanted into nude mice and used to test the effect of anti-VEGF antibody.The models were seperated into control groups and experimental groups(using anti-VEGF antibody).The TUNEL,PCNA and MVD were used to evaluate the effects of apoptosis,proliferation and angiogenesis.Results The explants in the control groups develop a rich blood supply that enables them to survive and grow than those in the experimental groups.The apoptosis in experimental groups was significantly higher than those of the control groups.The proliferation didn't show difference in these groups.The MVD in the control groups(human non-endometriosis 12.80?4.60,endometriosis 13.15?5.66;mouse non-endometriosis 29.7?19.6,endometriosis 34.6?16.3) were higher than those in the experimental groups(human non-endometriosis 7.17?2.25;endometriosis 7.32?1.30;mouse non-endometriosis 11.2?6.2;endometriosis 15.6?6.8).Conclusion Anti-VEGF antibody effectively interfered with the maintenance and growth of endometriotic-like lesions by disrupting the vascular supply.The anti-VEGF antibody may be provided a novel therapeutic approach for the treatment of endometriosis.