重组人卵透明带蛋白3融合蛋白表达载体的构建及表达

人卵透明带由三种糖蛋白组成，分别为ZP1，ZP2和ZP3。其中ZP3蛋白为四上与精子结合的特异性受体，故最为重要。在免疫性不孕症研究中，分离纯化四蛋白十分困难。本研究中，我们试图通过基因工程技术获得大量所需的人ZP3融合蛋白，并以此制备抗人ZP3的抗血清，以为免疫性不孕症的研究提供重要的制剂。     

不孕病人初诊的心理调查及护理

不孕症是指有正常性生活,未避孕1年未妊娠者[1]。据统计,我国不孕症的发病率为8%～15%(其中女方因素占60%)[2],并呈逐年上升趋势。不孕症虽一旦被确诊会引发情感及临床两方面问题[3]。为初步了解桂林市不孕症的基本情况,     

氧化应激反应与精子DNA碎片检测在男性不育症中的应用

世界卫生组织把不孕症定义为女方或男方生殖系统疾病, 指男女双方在没有采取避孕措施情况下, 有规律性生活1年或以上, 但女方仍未能受孕[1]。不孕症属于常见病, 我国不孕症的总体患病率为15.5%, 而在积极争取怀孕的夫妇中患病率高达25.0%[2]。不孕症严重影响患者的心理健康和生活质量, 并给家庭和社会带来沉重的经济负担, 是重大的公共卫生问题[3]。如果不孕的原因是男方因素导致, 则称之为男性不育。已知50%的不孕不育与男性有关, 其中约30%是单独男性因素引起的[4]。男性不育可以表现为精子质量变差, 如少精子症、弱精子症或畸精子症;临床上少、弱、畸精子可以同时存在, 称为少弱畸精子症。精子质量异常是直接导致男性不育的主要原因之一[5]。因此, 临床上常把精液分析作为男性不育诊断的第一步[6]。有研究表明, 精液质量参数如前向运动精子百分率和前向运动精子数与自然妊娠率相关[7]。然而, 精子数量、活力及形态这些基础或常规精液指标并不能全面反映男性的精子质量或生育能力, 也不能提示造成少弱畸精子症背后的原因或机制[8]。近年来, 有研究发现精子DNA完整性受损, 如DNA碎片化(s...     

超短波并“音频电”综合治疗继发性不孕症43例

据统计继发性不孕症大部分合并有输卵管炎和盆腔炎[1] ,妇科常规治疗一般用抗生素消除炎症 ,疗效较差[2 ] 。我科采用超短波与“音频电”综合治疗继发性不孕症 ,并与单纯药物治疗对比 ,1年后随访疗效优于单纯用药物组。资料和方法　　继发性不孕症患者 69例 ,均测基础体温并经Ｂ超检查证实确有排卵 ,排除男性不孕因素。年龄2 6～ 39岁 ,病程 2～ 14年 ;患者均有不同程度的下腹痛、腰痛、白带异常或经期延长等盆腔炎症状。综合治疗组 4 3例 ,其中 38例行清宫手术 ,2次手术18例 ,Ｂ超示盆腔包块 2 3例 ,大小 2～ 4ｃｍ ;输卵管积水 8例 ,输卵…     

不孕症病人婚姻适调的研究

不孕是特殊的疾病，是一种生殖功能状态^[1]。不孕症的发病率估计占育龄妇女的8％。由于治疗的不确定性和辅助生殖技术高昂的费用，使得不孕症夫妻普遍存在较大的心理和经济压力，持续的压力可造成个人痛苦、夫妻感情破裂、家庭不和等社会问题^[2]。不孕影响病人的心理活动^[3]。     

子宫内膜异位症引起不孕的诊治进展

<正>1 EMT与不孕的关系子宫内膜异位症(endometriosis,EMT)是妇科常见疾病,其发病率在一般人群中为1%~7%,且与不孕症密切相关,EMT患者中不孕症的发病率占30%~50%,而不孕症的患者中EMT占30%~58%[1]。现代医学对于轻微的EMT合并不孕症的治疗至今没有统一,多采用期待疗法。但期待疗法只能缓解临床症状,不能提高其妊娠率,目前研究[2]认为腹腔镜手术是EMT合并不孕患者的首选,而更多还原     

基于“血实宜决之”理论辨治多囊卵巢综合征不孕症经验总结

<正>多囊卵巢综合征(polycystic ovary syndrome,PCOS)是以卵泡发育障碍、雄激素分泌过多、胰岛素抵抗为特征的常见妇科内分泌代谢性疾病^[1],影响着6%～21%的育龄期女性^[2]。PCOS是不孕症的独立危险因素,与正常育龄期女性相比,PCOS患者发生排卵障碍性不孕的概率增加15倍^[3]。     

子宫内膜异位症与生活质量的相关研究进展

<正>子宫内膜异位症(endometriosis,EMT)主要表现为进行性持续加重的经期腹痛、慢性盆腔痛、不孕症等,对女性生活质量造成严重影响[1-2]。通过评估EMT患者生活质量,可更好地了解EMT及其相关治疗对患者生理及心理的影响,以更好地评价治疗效果[3]。本文就近年EMT与生活质量的相关研究综述如下。1 EMT症状与生活质量的研究1. 1疼痛与生活质量多数EMT患者表现为经期     

体外受精胚胎移植患者焦虑抑郁情绪研究进展

妊娠和分娩是女性的重要经历,女性无避孕性生活至少12个月而未怀孕称为不孕症[1]。不同人种和地区之间不孕症发病率差异并不明显,我国育龄人群中不孕不育症的发病率呈逐年升高的趋势,目前已达到10%~15%[2]。女性不孕症常见病因包括输卵管病变、排卵障碍、盆腔炎症及其后遗症、子宫体病变、子宫颈因素、子宫内膜异位症、先天性发育畸形、内分泌因素、免疫因素及不明原因等。男性不育症主要包括生精障碍和输精障碍。受中国传统观念影响,不孕不育症可能会给患者带来痛苦,并伴随着许多心理和社会问题,如抑郁、焦虑、社交孤立和性功能障碍[3]。有研究已经注意到体外受精(IVF)治疗相关的心理困扰,研究结果表明接受不孕症治疗和随后的IVF可能导致10%~50%的女性出现抑郁和焦虑症状[4-5]。     

不孕症患者宫腔镜检查61例分析

我们采用宫腔镜在诊断病因同时进行镜下治疗效果满意 ,现分析如下 :1　资料和方法1 .1　一般资料按《不孕不育》诊断标准[1] 自 2 0 0 2年 3月～2 0 0 2年 7月门诊诊治不孕症病人 61例 ,部分为不孕症常规检查 ;部分病人经多次通液或子宫输卵管碘油造影 (ＨＳＧ) ,提示输卵管不畅或通而不畅 ;部分病人经Ｂ超或阴超检查为子宫纵隔、宫腔占位。不孕年限为 2～ 1 4年 ,年龄 2 4～ 3 8岁 ,平均 2 6.4岁 ,其中异位妊娠切除一条输卵管 2例 ,原发性不孕症2 2例 ,继发性不孕症 3 9例 ,继发性不孕症有 1 9人次行一次或多次的人流术或药流术。1 .2　方…     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.