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绝经后子宫肌瘤增大86例临床及病理分析
目的 研究绝经后增大的子宫肌瘤的临床表现及病理特征.方法 选取2014年1月至2016年1月首都医科大学附属北京妇产医院经手术治疗的86例绝经后子宫肌瘤增大患者为研究对象,分析其临床临床表现、合并其他妇科疾病情况、手术病理情况以及子宫肌瘤变性与患者年龄、绝经年限、肌瘤直径、肌瘤类型、血流信号的相关性.结果 86例患者中无明显症状者61例,阴道出血者11例、腹痛者6例、下腹坠胀者4例、尿频者4例.子宫肌瘤发生变性者20例,其中玻璃样变17例、红色变1例、黏液变性1例、脂肪变性1例.子宫肌瘤变性与患者年龄、绝经年限、肌瘤直径、肌瘤类型、肌瘤有无血流信号无关(P&0.05).特殊类型子宫肌瘤10例,其中子宫脂肪平滑肌瘤5例、富细胞型平滑肌瘤3例、静脉内平滑肌瘤1例、奇异型平滑肌瘤1例.低度恶性子宫内膜间质-平滑肌肿瘤1例.子宫肌瘤合并子宫内膜增生6例,其中单纯性增生2例、复杂性增生1例、非典型性增生3例;合并子宫内膜息肉1例;合并卵巢肿物18例,其中浆液性囊腺瘤15例、卵巢单纯囊肿1例、子宫内膜异位囊肿1例.结论绝经后增大的子宫肌瘤大多无症状,有症状者以阴道出血多见.肿瘤本身恶性病变的发生率低,对无症状患者可严密随访,对有症状的患者应高度重视,积极治疗.
Abstract：
Objective To investigate the clinical and pathological characteristics of growing uterine leiomyoma in post -menopausal women .Methods A total of 86 postmenopausal patients with growing uterine leiomyoma treated by operation in Beijing Obstetrics and Gynecology Hospital from Jan .2014 to Jan.2016 were collected,to investigate the clinical manifesta-tion,existence of other gynecological diseases , surgical pathology and the relationship between patients age , menopausal period,myoma diameter and blood flow signal .Results Among the 86 patients,asymptomatic 61 cases,vaginal hemorrhage 11 cases,abdominal pain 6 cases,hypogastrium bulge 4 cases,frequent micturitio 4 cases.There were 20 cases with degen-eration,including 17 cases of hyaline degeneration ,1 case of red degeneration ,1 case of mucinous degeneration and 1 case of fatty degeneration .There was no correlation between uterine leiomyoma degeneration and age ,menopausal year ,leiomyoma diameter,leiomyoma type,leiomyoma blood signals(P&0.05).There were 10 cases of special types of uterine leiomyomas , including 5 cases of uterine lipoleiomyomas ,3 cases of cellular leiomyomas ,1 case of intravenous leiomyomatosis and 1 case of bizarre leiomyoma .There was 1 case of low-grade endometrial stroma-smooth muscle tumour .There were 6 cases of hyste-romyoma combined with endometrial hyperplasia ,including 2 cases of simple hyperplasia ,1 case of complex hyperplasia and 3 cases of atypical hyperplasia .There was 1 case accompanied with endometrial polyp ,18 cases accompanied with ovarian tumors,including 15 cases with serous cystadenoma ,1 case with simple ovarian cyst and 1 case with endometriotic cyst . Conclusion Most of postmenopausal patients with growing uterine leiomyoma are symptomless ,while the common symptom is vaginal hemorrhage .The incidence of malignant lesions of postmenopausal growing uterine leiomyoma is low .The patients without symptoms should receive close follow-up,more attention should be paid to the patients with symptoms and active treatment should be delivered .
作者单位：
首都医科大学附属北京妇产医院妇科微创中心,北京,100006
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万方数据知识服务平台--国家科技支撑计划资助项目（编号：2006BAH03B01）(C)北京万方数据股份有限公司
万方数据电子出版社子宫内膜间质细胞共培养促进月经血干细胞向子宫内膜上皮细胞分化的研究
Co-culture with endometrial stromal cells promotes the differentiation of menstrual blood-derived mesenchymal stem cells into endometrial epithelial cells
目的 体外诱导月经血子宫内膜间充质干细胞(MenSC)向子宫内膜上皮细胞分化.方法 培养MenSC和子宫内膜间质细胞(ESC)并鉴定,将MenSC与ESC共培养,同时补充生长因子(TGF-β1 10 ng/ml,EGF 10 ng/ml,PDGF-BB 10 ng/ml)和雌激素(17-β-雌二醇1×10-7 tool/L),之后免疫荧光染色检测分化的MenSC是否表达上皮细胞特异标记细胞角蛋白(CK).结果 MenSC生长良好,10代以内均表现出明显的梭状形态,结构紧密,其表面标记CD44、CD90、CD73和CD29表达率分别为98.4％、90.77％、94.75％和97.01％.ESC特异标记波形蛋白表达阳性.MenSC与ESC共培养3周后细胞形态基本由成纤维样向上皮样细胞转变,免疫荧光鉴定诱导分化后的MenSC表达细胞角蛋白.结论 在ESC共培养环境的诱导下,MenSC可向子宫内膜上皮细胞分化.细胞生长因子和雌激素在这一进程中发挥重要作用.
Abstract：
Objective To study the potential of differentiation of menstrual blood-derived mesenchymal stem cells (MenSC) into endometrial epithelial cells (EEC) in vitro.Methods Endometrial stromal cells (ESC) and MenSC were cultured and identified by certain methods.MenSC were co-cultured with ESC,added 10 ng/ml TGF-β1,10 ng/ml EGF,10 ng/ml PDGF-BB and 1 x 10-7 mol/L 17-β-estradiol.The expression of cytokeratin,which was marker of EEC,was tested by immunofluorescence in differentiated MenSC.Results MenSC proliferated quickly in vitro,and showed fusiform shape and clear structure within 10 generations.The expression rate of superficial markers of MenSC,CD44,CD90,CD73,and CD29,were 98.4％,90.77％,94.75％ and 97.01％ respectively.The expression of vimentin,which was stromal marker,was positive in cultured ESC (P3).Mter co-cultured with ESC for 3 weeks,MenSC morphology changed from fibroblast-like ceils into epithelial-like cells.Immunofluorescence assay showed that the differentiated MenSC expressed cytokeratin.Conclusion Under the condition of co-culture with ESC,MenSC has the ability to differentiate into endometrial epithelial cells.Cell growth factor and estrogen play the important roles in this process.
Jiang Yinshen
Zhu Haiyan
Jin Xiaoying
Zhang Yanling
Zhang Songying
浙江大学医学院附属邵逸夫医院,杭州,310016
& ISTICPKU
年，卷(期)
Keywords：
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国家自然科学基金，浙江省自然科学基金，浙江省重点研发计划项目()The Research was Supported by Grants from the National Natural Science Foundation of China，Zhejiang Provincial Natural Science Foundation of China，the Key Research and Development Program of Zhejiang Province
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&&8:00-11:30,13:00-17:00(工作日)月经周期38天的，是不是要月经延期一周才能用早孕试纸测出怀孕？
来自妈妈帮社区：
是什么情况
是怀了 还是没怀呢
我也相知道怀了吗
我也和你一样，月经周期长
我也和你一样，月经周期长
和别人排卵期不太相同，唉～，所以卵泡发育和排出情况都不好预测
和别人排卵期不太相同，唉～，所以卵泡发育和排出情况都不好预测
我也在等消息
我的情况跟你很像，周期35-38天，，5月11日末次月经，6月1号早上AA了一次，到现在也还没来DYM。11日当天重感冒，实在没抗住，吃了一次感冒清软胶囊和消炎药。
我也是，11号月经，4号才排卵，都过了五天，不知道什么情况
我的情况跟你很像，周期35-38天，，5月11日末次月经，6月1号早上AA了一次，到现在也还没来DYM。11日当天重感冒，实在没抗住，吃了一次感冒清软胶囊和消炎药。
亲，我和你一样上个月11号末次月经，周期经常推迟，刚才测也是白板，难过
亲，我和你一样上个月11号末次月经，周期经常推迟，刚才测也是白板，难过
你好孕了吗？我6月18号来DYM了，悲剧。
你好孕了吗？我6月18号来DYM了，悲剧。
没有啊，难过
和你情况差不多，尿，血测都一是怀孕，可我真的有孕前反应
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