ABSTRACT
Objective To investigate the effects of mifepristone on the expression of fibronectin (FN) in human villus and deciduas after termination of pregnancy. Methods Women with choice of termination of pregnancy(< 49 d) were divided into medical abortion complete group (n=15), medical abortion incomplete group(n=15) and control group (with dilatation and curettage, n=15). The villus and deciduas were collected at the third day of medical abortion or at the day of dilatation and curettage. Immunohistochemical technique was used to examine the expression of FN in villus and deciduas of these three groups. Results The positive expression rates of FN in villus and deciduas of control group were significantly higher than those of two medical abortion groups(P < 0.017), and the positive expression rates of FN of medical abortion incomplete group were significantly higher than those of medical abortion complete group (P < 0. 017). Conclusion Mifepristone can decrease the expression of FN in human villus and deciduas and interfere the condition of embryonic growth, exerting the anti-gestational effect at extracellular matrix level.
ABSTRACT
The growth and invasion of ectopic endometrium in endometriosis depends on hormone which will work in combination with its receptors.This review introduces the construction,function,gene,subtypes of estrogen receptor and progesterone receptor and their expressions in eutopic and ectopic endometrium,and explores their significance in the genesis,development,treatment and prognosis of endometriosis.
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Objective To study the effects of mifepristone on the expression of estrogen receptor(ER)? and progesterone receptor(PR) in the endometrium of patients with adenomyosis in different menstrual cycles. Methods Forty-seven patients with adenomyosis and 15 normal subjects were divided into 3 groups: mifepristone group(n=24),non-drug group(n=23) and control group(n=15).The expression of ER? and PR in eutopic,ectopic and normal endometrium in proliferative phase and secretory phase were detected by immunohistochemistry. Results In non-drug group,the expression of ER? and PR in ectopic endometrial glandular and stromal cells was significantly lower than that in eutopic and normal endometrium(P0.05).The expression of ER? and PR in both ectopic and eutopic endometrial glandular and stromal cells in mifepristone group was lower than that in the non-drug group(P
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Objective To study whether the mechanism of mifepristone in treating adenomyosis is suppressing matrix metalloproteinase-9 and tissue inhibitors of metalloproteinase-1(MMP-9/TIMP-1). Methods Thirty-five patients in the mifepristone treated group(19 cases of adenomyosis) and the control group(16 cases of adenomyosis,non-drug treated) underwent hysterectomy.Endometrium was looked as eutopic endometrium and adenomyosis as ectopic endometrium.Expression of MMP-9 and TIMP-1 in eutopic and ectopic endometrium were measured by immunohistochemical techniques. Results The ectopic endometrium of the mifepristone treated group expressed lower level of MMP-9,higher level of TIMP-1 and lower ratio of MMP-9/TIMP-1 than the ectopic endometrium of the control group(P
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Objective To study the incidence of complications of visceral and vascular injury in laparoscopic surgery for gynecologic diseases,and to discuss the ways to decrease the incidence. Methods The data of 2684 patients who received laparoscopic surgery from Januray 2003 to December 2005 in the Department of Obstetrics and Gynecology were reviewed retrospectively.The incidence and treatment of complications of visceral and vascular injury were observed. Results The total incidence rate of complications was 2.53%(n=68),and that of the visceral and vascular injury was 0.37%(n=10).Four cases of injury were related with trocar punctures(injury of omental blood vessel,n=2;postperitoneal vessel,n=2),three took place during the operation (severe bleeding,n=1;bladder injury,n=2),and the other three were observed in the postoperative stage(ureter injury,n=2;intestinal fistula,n=1). Conclusion The complications in laparoscopic surgery for gynecologic diseases are increased with the extension and difficulty of operation,and are closely related with the experience of the surgeons.Proper candidates for the surgery and established operative technique are the key factors in decreasing the incidence.