昆明山海棠片所致大鼠睾丸损伤的病理学研究

目的:观察昆明山海棠片连续给药90 d对大鼠睾丸结构的损伤。方法:80只SD雄性大鼠随机分为5.0 g/kg、10.0 g/kg、20.0 g/kg 3个给药组及正常对照组(等量蒸馏水),连续灌胃3个月。于给药1个月、2个月、3个月,采用光学显微镜、透射电子显微镜观察睾丸组织形态学的变化。结果:各给药组均可引起大鼠生精细胞损伤和破坏;睾丸超微结构的改变主要包括各级生精细胞坏死、空泡化,细胞质内溶酶体数量增多,线粒体肿胀、固缩,内质网扩张,细胞核染色质异常分布、溶解、固缩,核崩解消失等;支持细胞、间质细胞未见明显异常。结论:昆明山海棠片连续给药主要导致大鼠睾丸生精细胞超微结构损伤,其损伤存在剂量效应和时间效应关系。     

短期糖尿病大鼠睾丸的细胞学变化

目的:探讨糖尿病发病初期大鼠发生性与生殖功能障碍的细胞学机制。方法:通过给成龄雄性大鼠腹腔注射链脲菌素制成糖尿病动物模型,分别观察1d、3d、5d、7d、14d。观察期满后断头处死,取睾丸。应用常规组织学方法观察睾丸组织形态的改变;应用流式细胞分析术检测睾丸间质细胞、支持细胞及各级生精细胞的细胞周期的改变。结果:睾丸间质细胞及生精细胞的形态、数目从致病d7开始有明显变化,支持细胞的形态无明显变化;睾丸中各类细胞在高糖环境下24h即发生增殖减慢、细胞滞留在G1期、DNA合成减少等改变。结论:糖尿病大鼠生殖功能障碍与睾丸间质细胞、生精细胞的形态、数目变化及睾丸各类细胞的增殖改变有关。     

雷公藤多甙对大鼠生精细胞及其酶活性的影响

本文连续观察了雄性大鼠服用雷公藤多甙(GTW)30至80d 后睾丸、附睾细胞形态学改变及睾丸 ACP、ALP、3β-HSD、睾丸和附睾生精细胞 LDH-C_4活性的变化;同时注意了药物抗生育作用的可逆性。结果表明:附睾精子先于睾丸生精细胞发生质和量的变化;支持细胞 ACP 活性有增强趋势;睾丸 ALP,LDH-C_4酶活性相对减弱,为生精细胞损伤的结果;用药80d 时,3β-HSD 活性则明显减弱。结果还提示 GTW 引起的不育似有恢复的可能。     

雷公藤单体(TW_(19))雄性抗生育活性的研究

雷公藤单体(TW_(19))系从雷公藤中分离、提纯出的一个二萜类化合物,本实验观察其对雄性大鼠抗生育作用及可能机理.TW_(19)(400μg/kg·d)给药三周后无抗生育作用,五周后生育力丧失,附睾尾部精子活力和密度明显降低,畸形率升高,附睾重量减轻,但对附睾上皮的形态变化无明显影响,管腔内可见畸形精子及脱落生精细胞.附睾尾部液中肉毒碱含量,给药组较对照组显著降低.TW_(19)对附睾头部α-糖苷酶和酸性磷酸酶含量没有明显影响;对生精上皮影响轻微,各期曲细精管基本正常,少数表现出精子细胞轻度损伤;TW_(19)可使睾丸重量减轻,并可显著降低睾丸透明质酸酶含量,但对睾丸乳酸脱氢酶-C_4没有明显抑制作用;对前列腺、储精囊等附属性腺器官重量没有影响.结论:TW_(19)对雄性大鼠具有确定的抗生育效果,作用环节可能在精子细胞及附睾.     

Ⅱ型糖尿病雄性大鼠血清、生殖器官生物化学及组织学变化的实验研究

目的 :观察和探讨 型糖尿病雄性大鼠血清、睾丸、附睾和阴茎中 NO、NOS、SOD和 MDA含量的变化和相互关系 ,及其对雄性大鼠生殖器官的影响。方法 :4～ 6月龄 Wistar雄性大鼠 30只 ,随机分为 型糖尿病模型组 2 0只和对照组 1 0只。饲以高糖 -高脂饲料后 ,取血清及组织 ,光镜下观察各组织的病理改变 ,并测定各指标的变化。结果 : 型糖尿病大鼠模型制备成功 ;糖尿病大鼠与正常比较 ,显示睾丸曲细精管数量减少 ,管壁呈纤维样变 ;睾丸间质小血管内皮细胞增生 ,管壁纤维组织增生显著 ;附睾管腔内精子数量减少或缺如 ;阴茎海绵体平滑肌数量减少 ,纤维结缔组织增生。糖尿病大鼠血清及生殖器官中 NO含量和 NOS、SOD活性均显著低于对照组 ,MDA浓度明显高于对照组。相关分析表明 ,睾丸中 SOD活性与 MDA含量呈负相关 ,NO含量与 NOS活性呈正相关。结论 :II型糖尿病时睾丸、附睾及阴茎组织均受到不同程度的损害 ;糖尿病时自由基产生增加及清除障碍导致血清及生殖器官中 MDA、SOD与 NO、NOS发生变化 ,且这些变化可导致睾丸、附睾和阴茎功能紊乱 ,进而造成男性不育     

自发雄性不育近交系MIJ大鼠形态学特征观察

目的:了解本实验室培育的自发雄性不育近交系MIJ大鼠的形态学特征。方法:分别取1月龄、2月龄、3月龄不育大鼠(不育组,A组)、近交系内正常大鼠(系内正常组,B组)、正常雄性Wistar大鼠(正常对照组,C组),观察生长发育情况,常规方法制备病理切片,观察睾丸、附睾等器官组织学变化;取骨髓,常规方法染色体制片,G显带,进行染色体分析。结果:不育组大鼠体重增长速度稍慢,生殖器官发育迟缓;1月龄时腹腔内隐睾;睾丸下降时间、精索长度、睾丸引带长度、睾丸系数、附睾系数均明显落后于其他二组;且睾丸生精上皮发育不全,附睾内精子数量明显减少;但染色体形态及数目均正常,未观察到畸变。结论:自发雄性不育近交系MIJ大鼠呈睾丸下降延迟、睾丸发育不全、少精等特征,可以作为人类男性不育研究的良好动物模型。     

叶下株干预盐酸氮芥损伤小鼠生精上皮波形蛋白的表达

目的:研究叶下珠植物(PU)提取物对盐酸氮芥(NH2)损伤睾丸生精上皮细胞骨架中间丝波形蛋白的保护作用。方法:以5mg/kgNH2腹腔注射雄性KM小鼠,制备生殖毒性模型,并以不同剂量(125mg/kg、250mg/kg、500mg/kg)PU干预,分别应用免疫组织化学染色、RT-PCR、Westernblotting检测各组小鼠睾丸组织波形蛋白分布、mRNA及蛋白质表达水平变化。结果:NH2处理后,睾丸组织内波形蛋白蛋白表达与正常对照组比较显著降低(P<0.01),并在PU干预后显著上调(P<0.01);与正常对照组比较,高剂量PU组睾丸内波形蛋白蛋白表达与正常对照组比无明显差异(P>0.05);高剂量PU+NH2组,波形蛋白蛋白表达较正常对照组及单纯高剂量PU组升高(P<0.01)。各组vimentin基因表达无明显差异(P>0.05)。结论:NH2处理及PU干预对波形蛋白基因转录无显著影响,其作用环节在翻译修饰水平;PU能有效干预NH2对小鼠睾丸组织波形蛋白蛋白表达的损伤。     

小鼠灌胃植物提取物一般生殖毒性试验

目的:通过在小鼠生殖细胞成熟周期给予不同剂量植物提取物,观察AS植物提取物对小鼠生殖能力及生殖系统的影响,为评价AS植物提取物的安全性提供依据。方法:KM种小鼠240只,随机分为4组,每组60只,雌雄各半。设1个溶剂对照组和3个给药组,给药剂量分别为100 mg/kg、300 mg/kg和900 mg/kg,分别相当于人临床拟用剂量的10倍、30倍和90倍。交配前雄鼠连续给药60 d,雌鼠连续给药14 d,雌雄鼠按1:1合笼交配,发现阴栓之日定为受孕d 0。交配后雌鼠给药至受孕d 6。观察指标包括:小鼠一般状况、体重变化;对生殖功能的影响。结果:雄鼠在给药后第2周3个剂量组体重均明显低于对照组(P<0.01);给药3周后低剂量组体重增长恢复至对照组水平,但中高剂量组体重仍显著低于对照组(P<0.05,P <0.01),并持续到给药结束。雌性小鼠在给药期间各组体重增长无明显差异。各组动物在3个发情周期内交配率均在90%以上,受孕率在70%以上,对照组生育率为86.7%,三个给药组分别为66.7%、73.3%及83.3%。发现阴栓平均天数对照组为2.9 d,低、中、高三个给药组分别为2.8 d、2.7 d、3.4 d。精子数目及精子形态异常率各组间无明显差异。观察精子活力发现各组均以Ⅱ、Ⅲ级居多。大体解剖检查未见明显的与给药相关的病理改变。睾丸、附睾、前列腺、精囊腺脏?     

间充质干细胞对衰老大鼠睾丸的影响

目的:探讨间充质干细胞(MSCs)延缓睾丸衰老的机制。方法:通过皮下注射D-半乳糖建立衰老大鼠模型的同时,大鼠尾静脉注射MSCs进行生物治疗;应用终浓度为20μmol/L荧光染料CFSE标记的MSCs回输大鼠体内,制作睾丸冰冻切片,在荧光显微镜下观察MSCs是否定位于睾丸;制作睾丸组织切片,观察睾丸组织微细结构变化并计数萎缩曲细精管的比例;采用硫代巴比妥酸和黄嘌呤氧化法分别检测血清和睾丸中丙二醛(MDA)含量和超氧化物歧化酶(SOD)活性;应用Real-time PCR和Western blotting检测睾丸组织中P16的表达。结果:MSCs能够归巢到衰老大鼠的睾丸并存活;MSCs治疗组与模型组相比,睾丸曲细精管管壁增厚,各级生精细胞层增多,曲细精管内成熟精子增多,间质细胞胞浆浓稠,染色质清晰;治疗组萎缩的曲细精管比例高于模型组(P<0.05);血清与睾丸中SOD的活性均明显增高、MDA含量也显著降低(P<0.05);与模型组相比,MSCs治疗组能够使衰老大鼠睾丸内的P16 mRNA和P16蛋白表达降低(P<0.05)。结论:MSCs下调P16的表达,可能是其改善衰老睾丸功能的机制之一。     

三七总皂苷对大鼠睾丸精子发生的影响

目的:探讨三七总皂苷(total saponins of Panax notoginseng,PNS)对大鼠睾丸曲细精管精子发生的影响。方法:20只雄性SD大鼠随机均分为对照组与3个实验组,每组5只动物。实验组经口灌胃分别给予含PNS300mg/kg(B组)、600mg/kg(C组)、900mg/kg(D组)的生理盐水1ml,对照组(A组)以等量生理盐水代替,连续给药14d。采用HE染色法观察睾丸曲细精管生精上皮和间质区的组织学改变,比较4组的睾丸每日精子生成量(DSP)和异常曲细精管率。结果:B和C组的睾丸组织学与A组的相似,D组的可见病理改变明显的曲细精管。3个实验组的间质区未见异常改变。3个实验组中以D组的DSP最低及异常曲细精管率最高,但3组的DSP和异常曲细精管率分别与A组的比较无统计学差异(P>0.05)。结论:本实验在组织学水平未显示PNS引起睾丸精子发生有显著的变化,但高剂量长期给予PNS对曲细精管的影响需予以重视。     

Anesthesia for cesarean section: minimizing risk and complications

Managing cesarean section anesthesia is challenging and fraught with hazards. Each anesthetic option has different maternal and fetal risks. Emphasis on regional anesthesia when possible and utilization of state-of-the-art monitoring such as pulse oximetry and end-tidal capnography will improve the anesthetic outcome.     

Peripartum cardiomyopathy and cesarean section: report of two cases and literature review

Introduction The anesthetic management of labor and delivery in patients with peripartum cardiomyopathy is not well defined. Using continuous spinal anesthesia with bupivacaine or combined spinal epidural anesthesia with ropivacaine in such rare clinical situations has not been previously reported.Case report We present two cases in which parturients with the diagnosis of peripartum cardiomyopathy presented in congestive heart failure for emergent Cesarean section. Continuous spinal anesthesia and combined spinal-epidural anesthesia were successfully employed as the anesthetic techniques for the procedures. Both patients remained hemodynamically stable during surgery and were discharged home on postoperative days 5 and 4 respectively.     

Effect of isoflurane on neutrophil phagocytic function during pregnancy

Objective: General anesthesia has been considered an independent risk factor for postcesarean infection, but the mechanism for this association has not been delineated. The purpose of this prospective investigation was to determine if phagocytic response of neutrophils was impaired by in vitro exposure to isoflurane, a commonly used anesthetic.Methods: Twelve milliliter venous blood samples were withdrawn from 18 term patients during labor. Neutrophils were separated by Ficoll gradient centrifugation. Aliquots of 2 x 10(6) neutrophils/ml were exposed to anesthesia using an airtight modular incubator chamber through which a 0.5% isoflurane:50% N(2)O + 50% O(2) mixture flowed at a rate of 4 l/min for 90 min at 37. Neutrophils were assayed for phagocytosis by incubation with Escherichia coli conjugated with fluorescein isothiocyanate for 30 min at 37. Phagocytosis was assessed by flow cytometry. Neutrophils from the same patient that were not exposed to anesthesia served as controls.Results: The mean percentage of phagocytizing neutrophils in the isoflurane-treated group was 82.8 +/- 24 compared to 83.5 +/- 22 in the control group. The difference between the two groups was not significant.Conclusions: In vitro exposure to the general anesthetic isoflurane for 90 min does not significantly alter the phagocytic capacity of neutrophils.     

Are obstetrical personnel required for intraoperative fetal monitoring during nonobstetric surgery?

OBJECTIVE: To determine if the scientific literature supports the practice of electronic monitoring of the fetal heart rate (FHR) during nonobstetric surgery. STUDY DESIGN: A search of the literature from 1966 to 1995 was performed using MEDLINE. RESULTS: No fetal hypoxic mortality or morbidity has been documented from nonobstetric surgery without occurrence of a maternal hypoxic complication regardless of the use of FHR monitoring or whether alterations of the FHR occurred. CONCLUSIONS: Fetal monitoring is an indirect assessment of maternal anesthetic and surgical management that is not as specific or effective as direct assessment of the maternal parameters to detect respiratory compromise. Current clinical evidence obtained does not substantiate the need for obstetric personnel to monitor FHR changes during surgical procedures because no change in fetal outcome has been documented.     

Building capacity for anaesthesia in low resource settings

Direct causes of maternal deaths are responsible for about 80% of maternal mortality in developing regions of the world. Death from any one of these can be prevented by the use of relatively inexpensive, simple medical interventions which includes the use of anesthesia and anesthetic techniques. Lack of anesthetic care and anesthesia has been recognized as a limiting factor to successful provision of life saving interventions that could prevent maternal deaths in low resource settings. Doctor anesthetists are few and the anesthetic care has been adequately provided by non doctor anesthetist in many of these settings. Increasing the numbers of non doctor anesthetists and strengthening their capacity where they exist, is a strategy which will contribute to maternal mortality reduction in such settings. Several UK based organizations have contributed to increasing the capacity to deliver anesthesia in developing countries over the past 15-20 years. Learning from their experiences, a high level of training in anesthesia for non doctors can be introduced or existing programmes improved upon. This article proposes a mechanism to achieve this through national and international links for resource poor settings.     

Simpson, Semmelweis, and transformational change

The first anesthetic for childbirth and the first recognition of the importance of hand hygiene in obstetrics coincidentally occurred within 5 months of one another in 1847. More than 150 years later, one would have thought that these milestone events would have been fully integrated into practice. However, individuals resist transformational change, which is defined as a fundamental alteration in their beliefs, attitude, and behavior, even when they are confronted with incontrovertible facts. This resistance to change may explain why, in 2005, a large percentage of health care providers still do not practice acceptable hand hygiene, and the pain of childbirth continues to be extolled by some as a necessary part of womanhood, just as pharmacologic pain relief is discouraged.     

General anesthesia in cesarean section: effect on mother and neonate

Advances in anesthetic techniques during the past several decades have resulted in an excellent outcome in infants delivered by cesarean section under general anesthesia. To understand these results, it is important to be familiar with the physiologic changes which occur during general anesthesia. A review of the literature which focuses on the findings which led to current anesthetic principles is presented.     

Local versus general anesthesia: Which is safer for performing suction curettage abortions?

The relative safety of suction curettage abortions performed with either local or general anesthesia has not been clearly established. To compare the safety of these two anesthetic techniques, we studied 36,430 women who received local anesthetics and 17,725 who received general anesthetics for this operation in the United States from 1971 through 1975. The aggregated major complication rates for the two groups were similar, but there were significant differences between local and general anesthesia for specific complications and treatments. Local anesthesia was associated with higher rates of febrile and convulsive morbidity; however, general anesthesia was associated with higher rates of hemorrhage, cervical injury, and uterine perforation. Both anesthetic techniques appear to be safe, with similar degrees of overall safety, although each is associated with a different spectrum of complications.     

Neurologic complication of labor analgesia: facts and fiction

Regional anesthesia has become a hallmark of modern obstetric anesthesia practice and a paramount technique for labor analgesia. Neurologic complications associated with present-day labor analgesia are thought to be unusual; however, they can occasionally complicate peripartum obstetric and anesthetic management of pregnant patients. To date, no review article in obstetric literature has specifically addressed the issue of possible neurologic anesthetic complications attributed to labor analgesia. Therefore, a series of systemic literature searches (Medline) to identify the articles on neurologic complication of labor analgesia was conducted. This review article summarizes the evidence from published articles on this topic, with particular emphasis on the mechanism of neurologic injury, lidocaine-related transient neurologic symptoms, anticoagulation and vascular compromise, diagnostic evaluation, and prevention of neurologic obstetric anesthesia-related neurologic injury in pregnancy.     

Influence of drug exposure of the father on perinatal outcome.

Initial skepticism that paternally administered drugs could damage the developing fetus has given way to concern that lead, narcotics, ethanol, anticonvulsants, anesthetic gases, caffeine, or cigarette smoke ingested at the time of conception might damage sperm or sperm motility or have indirect effects resulting in an increase in neonatal morbidity and mortality.