1型糖尿病儿童晚期糖基化终末产物、血清抗苗勒管激素和抑制素B对儿童生殖器官发育影响的研究

目的 研究1型糖尿病（type 1 diabetes mellitus,T1DM）对儿童生殖器官发育的影响。方法 选取6~10岁Tanner Ⅰ期T1DM患儿80例,其中女性患儿41例,男性患儿39例;健康对照组85例,其中女性患儿40例,男性患儿45例。对所有入组儿童均采集外周血检测血清晚期糖基化终末产物（advanced glycosylation end products,AGEs）、血清抗苗勒管激素（anti miillerian hormone,AMH）、血清抑制素B （inhibin B,INHB）、性激素4项和糖化血红蛋白A1c （glycosylated hemoglobin A1c,HbA1c）水平,分别比较上述指标在不同性别儿童T1DM组与健康对照组之间的差异。结果 女性患儿T1DM组血清AGEs、AMH、INHB、HbA1c水平均较女性患儿健康对照组明显升高,差异有统计学意义（P<0.05）;女性患儿T1DM组血清性激素4项水平与女性患儿健康对照组比较,差异均无统计学意义（P>0.05）;男性患儿T1DM组血清AGEs、AMH、HbA1c水平均较男性患儿健康对照组明显升高,差异有统计学意义（P<0.05）;男性患儿T1DM组血清INHB水平较男性患儿健康对照组则明显降低,差异有统计学意义（P<0.05）;男性患儿T1DM组血清性激素4项水平与男性患儿健康对照组比较,差异均无统计学意义（P>0.05）。结论 T1DM可能对儿童生殖器官发育成熟造成一定程度影响。     

腹腔镜下卵巢囊肿剔除术中电凝和缝合止血对卵巢储备功能的影响

目的 探讨腹腔镜下卵巢囊肿剔除术中电凝和缝合止血对卵巢储备功能的影响。方法 选取2018年1月—2020年11月青海省人民医院收治的卵巢囊肿患者200例作为研究对象，随机分为电凝组和缝合组，每组100例。比较两组患者手术前后抗缪勒管激素（AMH）、雌二醇（E2）、促卵泡激素（FSH）、黄体生成素（LH）水平，并分析其相关性。结果 电凝组与缝合组手术时间、术中出血量比较，差异无统计学意义（P >0.05）。术后1个月，两组窦卵泡数、卵巢动脉收缩期峰值血流速度少或慢低于术前（P <0.05）；且缝合组多或快于电凝组（P <0.05）。两组血清AMH、E2水平均低于术前（P <0.05），且缝合组高于电凝组（P <0.05）。两组血清FSH、LH水平均高于术前（P <0.05）；且缝合组低于电凝组（P <0.05）。Pearson相关性分析结果显示，术后血清AMH与E2水平呈正相关（r =0.553，P <0.05），与FSH、FSH/LH呈负相关（r =-0.614和-0.482，均P <0.05），与LH无相关性（r =0.115，P >0.05）。结论 相较电凝止血，腹腔镜下卵巢囊肿剔除术中应用缝合止血更有利于保护卵巢储备功能。患者术后血清AMH水平与E2、FSH、FSH/LH相关，AMH检测可作为辅助手段评价患者术后卵巢储备功能。     

基于核磁共振1H谱的乳腺纤维腺瘤与乳腺浸润性导管癌血清代谢组学比较研究

目的 分析乳腺纤维腺瘤患者及乳腺浸润性导管癌患者在血清代谢组学上的差异,探讨术前通过代谢特征来辨别良恶性肿瘤的可能性。方法 收集经临床确诊的乳腺纤维腺瘤和乳腺浸润性导管癌患者血清各8例,通过核磁共振¹H谱（¹HNMR）技术检测其血清代谢组特征,分别采用主成分分析（PCA）和正交偏最小二乘判别法 （OPLS-DA）分析乳腺纤维腺瘤与乳腺浸润性导管癌之间的代谢差异。结果 PCA和OPLS-DA分析显示乳腺纤维腺瘤患者和乳腺浸润性导管癌患者的血清代谢特征存在明显差异。与乳腺纤维腺瘤患者相比,浸润性导管癌患者血清中脂质、乳酸盐、磷脂酰胆碱/甘油磷脂酰胆碱的含量升高,而谷氨酰胺、牛磺酸、肌酸和葡萄糖含量降低。结论 乳腺纤维腺瘤患者与乳腺浸润性导管癌患者在血清代谢水平上具有明显差异,这些具有明显变化的代谢物可作为潜在血清代谢标记物,为临床区分良恶性肿瘤提供参考。     

基于氧化石墨烯/金纳米棒的表面增强拉曼散色技术检测循环肿瘤细胞

目的 开发一种结合表面增强拉曼散色（SERS）光谱与静电吸附的方法用于检测循环肿瘤细胞。方法 氧化石墨烯经过聚苯乙烯磺酸钠（PSS）的非共价修饰后,通过金种子法原位合成氧化石墨烯/金纳米棒（GO/GNR）复合材料,再利用聚-二烯丙基二甲基氯化铵（PDDAC）非共价修饰GO/GNR,使其表面带正电荷。通过电荷靶向作用实现GO/GNR与肿瘤细胞的靶向结合,用SERS技术对GO/GNR-肿瘤细胞复合物进行检测。采集健康志愿者血液标本,将不同密度的肿瘤细胞加入血液标本中制成模拟血样,按上述方法检测模拟血样中的肿瘤细胞。结果 带正电荷的GO/GNR复合材料能够有效地与肿瘤细胞靶向结合,并且能够在50~10 000个细胞的范围内对肿瘤细胞进行拉曼光谱检测,但白细胞对肿瘤细胞的检测有一定的干扰。结论 GO/GNR复合材料可作为SERS探针实现对循环肿瘤细胞的拉曼光谱检测。     

在体外受精-胚胎移植中应用多项卵巢储备功能评估指标预测卵巢反应性

目的分析卵巢储备功能评估指标与卵巢反应性的关系及对卵巢反应性的预测效能。方法队列研究分析行体外受精（IVF）/
单精子卵母细胞内注射(ICSI) 的331个取卵周期病例,并将病例分为正常反应组、低反应组以及高反应组3组,采用ELISA方法检
测患者月经第3天的血清抗苗勒氏激素（AMH）水平,同时超声测量双侧卵巢内基础窦状卵泡数（AFC）,血清基础卵泡刺激素
（FSH）、黄体生成素（LH）及雌激素（E2）采用化学免疫发光法检测。结果血清AMH水平、AFC、血清FSH水平、FSH与LH比值
（FSH/LH）、年龄均与获卵数×1000/促性腺激素（Gn）总安瓿数相关（P<0.001）;而基础E2与其不相关（P>0.05）。AFC及血清AMH
水平作为单一指标对于卵巢低反应的预测价值最好,其ROC曲线下面积分别为0.855（0.787~0.924）和0.832（0.764~0.900）,对卵
巢低反应的最佳预测界值点分别为AFC≤9个,AMH≤1.88 ng/ml。AFC是预测卵巢高反应的最好单一指标,其ROC曲线下面积
为0.787（0.728~0.847）,最佳预测界值点为AFC≥15个。Logistic逐步回归分析显示联合AFC、血清AMH水平以及血清FSH水
平指标能更好地预测卵巢低反应,但联合各指标并不能提高对卵巢高反应的预测效能。结论AFC、血清AMH水平、血清FSH水
平、FSH/LH、年龄均是卵巢反应性的预测指标,但是其敏感性、特异性不同。AFC作为单一指标对于卵巢反应的预测价值最好。联
合AFC、血清AMH水平及血清FSH水平能提高对于卵巢低反应的预测效能。而对于卵巢高反应,联合多指标不能提高预测效能。
     

罗格列酮改善脂多糖诱导慢性低度炎症大鼠的卵巢功能异常

目的 观察慢性低度炎症大鼠卵巢组织中过氧化物酶体增殖物激活受体（PPAR）的表达,并初步探究PPAR-γ激动剂罗格列酮对慢性低度炎症诱导的卵巢功能异常的影响。方法 以腹腔注射脂多糖（LPS）诱导的慢性低度炎症大鼠为动物模型。将200只大鼠随机分为对照组（NS组）和慢性低度炎症组（LPS组）,每组100只,分别予腹腔注射生理盐水和LPS干预。在发情周期不同阶段（发情前期、发情期、发情后期和发情间期）,通过检测2组大鼠血清中雌二醇（E2）、卵泡刺激素（FSH）、黄体生成素（LH）和抗苗勒管激素（AMH）评估卵巢功能,利用蛋白质印迹法检测卵巢组织中PPAR-α、PPAR-δ和PPAR-γ的表达情况。将2组各80只大鼠分别随机分为2个亚组,每个亚组40只大鼠,分别予生理盐水和罗格列酮灌胃干预。灌胃14 d后,观察各亚组大鼠在发情周期不同阶段卵巢组织中促炎细胞因子[白细胞介素（IL）-1β、IL-6和肿瘤坏死因子α（TNF-α）]水平和卵巢功能。结果 与NS组相比,在发情周期不同阶段,LPS组大鼠血清中E2和AMH水平均下降（P均<0.05）,FSH和LH水平均升高（P均<0.05）;卵巢组织中PPAR-γ表达均降低（P均<0.05）,而PPAR-α和PPAR-δ表达无明显变化（P均>0.05）。在发情周期不同阶段,LPS诱导的慢性低度炎症大鼠在口服罗格列酮后卵巢组织中促炎细胞因子IL-1β、IL-6和TNF-α水平均降低（P均<0.05）,并且LPS诱导血清中降低的E2、AMH和升高的FSH、LH均得以改善（P均<0.05）。结论 PPAR-γ激动剂罗格列酮可减轻LPS诱导的大鼠慢性低度炎症反应,并改善卵巢功能。     

肥厚型心肌病患者γ-谷氨酰转移酶水平与左心功能的相关性

目的 探究肥厚型心肌病患者左心功能与血清γ-谷氨酰转移酶（GGT）水平的相关性。方法 选择2013年10月至2015年6月安岳县中医院心内科经心脏超声诊断为肥厚型心肌病患者72例为肥厚型心肌病组,选择同期健康体检者72名为对照组,两组参与者均行血清学及心脏超声测定,记录血清GGT、三酰甘油、血糖、胆固醇以及左室射血分数（LVEF）、左室舒张末内径（LVD）,左心房容积（LAV）、二尖瓣瓣环组织多普勒速度（E''）、二尖瓣舒张晚期血流速度峰值（A值）、二尖瓣舒张早期血流速度峰值（E值）,计算左房容积指数（LAVI）以及E/E''和E/A。对比分析两组间各指标差异,采用Pearson分析超声测定的相关指标与血清GGT水平的相关性。结果 肥厚型心肌病组与对照组相比,其GGT、LVD、LAV、LAVI、E/E''升高,差异均有统计学意义（P均<0.05）。LVEF在两组间比较,差异无统计学意义（P>0.05）;血清GGT水平与E/E''、E/A、LAVI、LAV呈正相关关系（P均<0.05）,与LVEF、LVD不存在线性关系（P均>0.05）。结论 肥厚型心肌病患者的心室舒张功能与血清GGT水平存在密切的相关性,采用血清GGT水平与超声联合测定对肥厚型心肌病患者病程评估及早期诊断具有重大的指导意义。     

补肾养血方对卵巢早衰大鼠中抗苗勒氏管激素(AMH)的影响

目的 建立雷公藤多苷致卵巢早衰大鼠的模型,研究补肾养血方对卵巢早衰大鼠中抗苗勒管素（anti-mullerian hormone,AMH）的影响。方法 使用雷公藤多苷建立卵巢早衰大鼠模型,造模成功后,分别采用高,中,低剂量补肾养血方对大鼠灌胃,每日一次,共30 d。给药完毕后于显微镜下观察各组大鼠卵巢组织形态。酶联免疫吸附法、免疫组化染色法和定量反转录聚合酶连锁反应（qRT-PCR）分别检测大鼠血清中AMH含量以及卵巢内AMH的蛋白和mRNA表达水平。结果 组织形态学显示高中低剂量组的卵泡和黄体的生长均比模型组好;酶联免疫吸附法、免疫组化和qRT-PCR结果显示补肾养血方呈剂量依赖性逆转雷公藤多苷导致大鼠血清中AMH浓度以及卵巢中AMH表达水平的降低。结论 补肾养血方可逆转雷公藤多苷引起卵巢中AMH水平降低,提示补肾养血方具有防止卵巢早衰的功效。     

抗苗勒管激素对卵巢过度刺激综合征的预测价值

目的：评价抗苗勒管激素（anti-Müllerian hormone,AMH）对行体外受精（in vitro fertilization,IVF）-胚胎移植（embryo transfer,ET）治疗的患者并发卵巢过度刺激综合征（ovarian hyperstimulation syndrome,OHSS）的预测价值。方法：372例行IVF治疗的患者,60例发生OHSS,选择60例年龄匹配未发生OHSS的患者进行比较,分成OHSS组和非OHSS组。经期第2~4天测定血清促卵泡刺激素（FSH）、促黄体生成素（LH）、雌二醇（E2）和AMH水平,超声测定窦卵泡数（antral follicle counts,AFC）。用受试者工作曲线（ROC曲线）评价各指标对OHSS 发生的预测价值。结果：OHSS组血清FSH值较非OHSS组低,AFC较非OHSS组高,差异均有统计学意义(P均<0.05),体重指数（BMI）在两组间差异无统计学意义(P>0.05),OHSS组血清AMH值与非OHSS组间比较,差异有统计学意义（P<0.01）。 ROC曲线结果显示AMH的曲线下面积（AUC）为0.716,cut-off值取3.52 ng/mL时,灵敏度为0.933,特异度为0.533。结论：血清AMH可以用来预测OHSS的发生。     

抗缪勒氏管激素在评估卵巢储备功能中的应用

目的:探讨抗缪勒氏管激素（AMH）在评估卵巢储备功能中的应用及价值。方法:选择157例不孕症病人,根据月经第3天经阴道超声检测的窦卵泡计数（AFC）将病人分为观察组（AFC<5枚）和对照组（AFC≥5枚）,应用Cobas e411型全自动电化学发光免疫分析仪检测2组病人血清AMH、生殖激素水平,分别对2组观察指标进行比较。结果:与对照组比较,观察组的AMH水平明显降低（P<0.01）,黄体生成激素（LH）、卵泡刺激素（FSH）和雌二醇（E2）水平均明显上升（P<0.01）,睾酮水平差异无统计学意义（P>0.05）;Pearson相关分析显示,AMH水平与AFC、E2水平呈明显正相关关系（P<0.01）,与病人年龄、FSH水平呈明显负相关关系（P<0.01）。结论:血清AMH水平联合AFC、基础生殖激素水平可以预测、评估卵巢储备功能,AMH水平的变化早于基础生殖激素水平的改变,能更早期、更准确地预测卵巢储备能力的变化。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.