Hcy对行体外受精-胚胎移植治疗PCOS患者卵子质量及发育潜能的影响

目的探究同型半胱氨酸(Hcy)对行体外受精-胚胎移植治疗多囊卵巢综合征(PCOS)患者卵子质量及发育潜能影响。方法行体外受精-胚胎移植治疗PCOS患者70例为研究组,另选同期因输卵管因素行体外受精-胚胎移植治疗不孕患者69例为对照组,比较2组取卵日血浆、卵泡液Hcy浓度,统计2组卵子质量及发育潜能,分析Hcy浓度与优质胚胎率、卵裂率、受精率相关性。结果研究组取卵日血浆、卵泡液Hcy浓度均明显高于对照组(P0.05);卵子成熟率、卵子回收率、优质胚胎率、卵裂率、受精率均显著低于对照组(P0.05);Hcy浓度与优质胚胎率、卵裂率、受精率均呈明显负相关(P0.05)。结论 PCOS患者血浆、卵泡液Hcy浓度显著升高,是导致卵子质量及发育潜能较低重要原因。     

超促排卵过程中加用电针干预对体外受精—胚胎移植患者妊娠结局的影响

目的探讨超促排卵(COH)过程中加用电针干预对体外受精—胚胎移植(IVF-ET)患者卵子质量及妊娠结局的影响。方法选择接受IVF-ET的患者224例,其中多囊卵巢综合征(PCOS)141例,非PCOS 83例。将P-COS患者和非PCOS患者分别分为电针组与对照组,均给予促性腺激素释放激素激动剂(GnRH-a)长方案进行COH,电针组加用电针干预,取穴关元、中极、三阴交、子宫、太溪、丰隆。比较各组的妊娠结局。结果 PCOS患者电针组临床妊娠率较对照组提高10.78%,受精率、卵裂率、优质胚胎率较对照组变化明显(P均<0.05);非PCOS患者两组相关指标无明显差异,妊娠组血清、卵泡液SCF水平高于非妊娠组(P<0.05)。结论对IVF-ET患者在COH过程中进行电针干预可提高临床妊娠率,PCOS患者对电针刺激较非PCOS患者敏感。     

祛瘀解毒颗粒联合IVF-ET治疗子宫内膜异位症不孕疗效观察

将82例子宫内膜异位症（EM）不孕患者随机分为治疗组42例和对照组40例,两组均行外受精—胚胎移植,治疗组先行口服祛瘀解毒颗粒3个月。结果与对照组比较,治疗组卵丘颗粒细胞凋亡率明显降低,卵细胞质量、受精率、卵裂率、优质胚胎率、临床妊娠率明显提高。认为祛瘀解毒颗粒辅助治疗可提高EM不孕患者的妊娠率,可能与其提高卵细胞质量、调节机体免疫功能有关。     

精子质量对不孕不育患者辅助生殖技术选择的指导作用

目的探讨精子质量对不孕不育患者辅助生殖技术选择的指导作用。方法选择201对行常规体外受精胚胎移植术(IVF-ET)的不孕不育夫妇,其中行IVF-ET成功(二极体的胚胎数量占胚胎总数≥30%)者126对(IVF-ET组),IVF-ET失败(二极体的胚胎数量占总胚胎数<30%)后行补救卵胞浆内单精子注射术(R-ICSI)75对(R-ICSI组)。比较两组精液常规、精子DNA完整率、精子顶体完整率、顶体反应率;体外受精后比较两组受精率、优胚胎率。结果 IVF-ET组精子密度、活力及正常形态率均高于R-ICSI组(P均<0.05);R-ICSI组精子DNA断裂指数(DFI)明显高于IVF-ET组(P<0.05),顶体完整率、顶体反应率两组比较无统计学差异(P均>0.05);R-ICSI组受精率、优胚率低于IVF-ET组(P均<0.05)。结论当精子密度低于11.1×106/m L,正常形态率低于1.4%,DFI高于15.9%,顶体完整率低于77.3%,顶体反应率低于15.7%时建议直接行R-ICSI助孕。     

拮抗剂添加日血清LH水平不同的不孕症患者GnRH-ant灵活方案促排卵后IVF-ET移植效果观察

目的 比较拮抗剂添加日不同水平的血清促黄体生成素（luteinizing hormone, LH）在促性腺激素释放激素拮抗剂（gonadotropin-releasing hormone antagonist,GnRH-ant）灵活方案中对不孕症患者体外受精—胚胎移植（In Vitro Fertilization and Embryo Transfer, IVF-ET）妊娠结局的影响。方法 607例接受灵活的拮抗剂方案的不孕症患者,根据拮抗剂添加日血清LH水平分为LH<10 mIU/mL 189例（A组）、10 mIU/mL≤LH<20 mIU/mL 285例（B组）及LH≥20 mIU/mL 133例（C组）。观察并记录三组患者获卵数、卵子成熟率、2PN受精率、卵裂率、优质胚胎率、鲜胚种植率、新鲜周期移植率、临床妊娠率、流产率及活产率。结果 与A组比较,B组患者卵裂率、优质胚胎率及活产率高,流产率低（P均<0.05）;与B组比较,C组卵裂率、优质胚胎率及活产率低,流产率高（P均<0.05）。结论 拮抗剂添加日血清10 mIU/mL≤LH<20 mIU/m...     

血清及卵泡液VEGF水平在预测胚胎早期种植中的价值

目的研究取卵日卵泡液及取卵日、移植日、移植后3、7、14 d血清血管内皮生长因子(VEGF)的表达水平,探讨血清及卵泡液VEGF的水平与人类胚胎早期种植的相关性以及与体外受精—胚胎移植(IVF-ET)结局的关系。方法对50例行IVF-ET助孕的不孕患者(其中原发不孕25例,继发不孕25例)在取卵日采集卵泡液,并在取卵日、移植日及移植后3、7、14 d分别采集静脉血3 mL。按妊娠结局将50例不孕患者分为妊娠组和非妊娠组,分析血清及卵泡液VEGF的表达水平与胚胎早期种植相关性以及与IVF-ET结局的关系。结果移植后7、14 d妊娠组血清VEGF水平高于非妊娠组(P均<0.05);妊娠组胚胎移植后血清内VEGF水平呈逐渐上升的趋势,非妊娠组胚胎移植3 d后则呈逐渐下降的趋势;两组取卵日卵泡液内VEGF水平高于血清(P均<0.05);妊娠组受精率、优质胚胎率高于非妊娠组(P均<0.05)。结论动态监测IVF-ET后血清VEGF的表达水平可以预测胚胎的早期种植。取卵日卵泡液内VEGF的表达水平影响受精率、优胚率,从而影响妊娠结局。     

冷冻胚胎解冻后单胚胎移植的可行性探讨

目的 探讨冷冻卵裂期胚胎解冻(FET)后单胚胎移植的可行性.方法 选取我院收治的不孕患者249例,按照胚胎移植数量分为单胚胎移植组(60例)、双胚胎移植组(168例)、三胚胎移植组(21例),观察胚胎移植情况及临床妊娠情况;双胚胎移植组按胚胎优劣分为双优质胚胎移植组(103例)、单优质胚胎搭配非优质胚胎移植组(50例)、无优质胚胎移植组(15例),观察胚胎移植情况、临床妊娠情况及多胎发生情况.结果 单胚胎移植组、双胚胎移植组、三胚胎移植组胚胎种植成功分别为18个(30％)、97个(28.87％)、13个(20.63％),三组比较P均＞0.05;临床妊娠分别为18例(30％)、77例(45.83％)、7例(33.33％),单胚胎移植组与双胚胎移植组比较P＜0.05.双优质胚胎移植组、单优质胚胎搭配非优质胚胎移植组、无优质胚胎组胚胎种植成功分别为65个(31.55％)、26个(26％)、6个(20％),两两比较P均＞0.05;临床妊娠分别为47例(45.63％)、25例(50％)、5例(33.33％),两两比较P均＞0.05;多胎发生分别为18例(38.30％)、1例(4％)、1例(20％),双优质胚胎移植组与单优质胚胎搭配非优质胚胎移植组比较P均＜0.01.结论 FET后单胚胎移植可行,选择优质胚胎进行单胚胎移植能够获得满意的胚胎种植和临床妊娠结果.     

不同取精方式对卵泡浆内单精子注射妊娠结局的影响

目的探讨不同取精方式对卵泡浆内单精子注射（ICSI）结局的影响。方法回顾性分析在本中心接受治疗的不育夫妇78例,共81个周期,根据精子来源不同分别治疗：射出精子严重少、弱、畸精症者,行ICSI53个周期;经附睾穿刺（PESA）或睾丸切开取精（TESE）者,行ICSI28个周期。比较ICSI后两组的受精率、优质胚胎率、卵裂率及临床妊娠率。结果两组分别穿刺MⅡ期成熟卵子457、359个,自取精液组受精率明显高于附睾或睾丸取精组,而优质胚胎率、卵裂率、临床妊娠率两组无显著差异。结论ICSI使用不同来源精子不影响其妊娠结局,是治疗男件不育的有效方法。     

促性腺激素脉冲式给药在体IVF-ET中的应用效果观察

目的观察促性腺激素（Gn）脉冲式给药在体外受精—胚胎移植（IVF-ET）中的应用效果。方法将117例不孕患者随机分为A组38例、B组39例、C组40例,均行IVF-ET治疗,超排卵的第1～5天应用尿源性促卵泡生成素（uFSH）,第6天开始使用uFSH、绝经期促性腺激素（HMG）。A组、B组将每日Gn用量等分为4份,分别于8：00、11：00、14：00、17：00皮下注射或肌注;C组将每日Gn用量予1次/d肌注。结果与C组比较,A、B组用药量及费用减少（P均〈0.05）,受精率、卵裂率、优质胚胎率及临床妊娠率显著提高（P均〈0.05）,A、B组比较,P〉0.05。结论 Gn脉冲式给药用于IVF-ET经济、有效。     

精子顶体完整性对IVF-ET结局影响的研究进展

自体外受精-胚胎移植(IVF-ET)发展以来,IVF-ET已成为常规辅助生殖技术,协助许多不孕夫妇解决生育问题,但同时尚有许多问题需要解决,诸如体外受精率低下、较低的临床妊娠率及如何保证移植胚胎发育质量等。精子顶体完整性与男性不育关系密切,近年来越来越多的国内外学者关注到精子顶体完整性与IVF-ET结局的关系。该文综述了精子顶体相关知识及精子顶体完整性对IVF-ET受精率、卵裂率、优胚率、胚胎种植率、临床妊娠率、活产率、流产率等结局的研究进展情况。     

青少年高血压的研究进展

随着人们生活和行为方式的改变,高血压发病明显呈年轻化趋势。在青少年时期识别高血压病高危人群有助于早期进行有效干预和治疗,降低未来高血压的发生率及其严重性。现试从青少年高血压的诊断、发病因素、特点、治疗策略等方面的研究进展作一综述。     

Morbidity in cardiovascular diseases in immigrants in Sweden

INTRODUCTION: Although immigration to Sweden has increased in the last few decades, the incidence rates of cardiovascular disease and coronary heart disease in immigrants are unknown. The aim of the present study is to estimate whether place of birth affects the incidence rates of cardiovascular disease and coronary heart disease. MATERIAL AND METHODS: The study was designed as a follow-up study on morbidity in cardiovascular disease and coronary heart disease between 1 January 1997 and 31 December 1998, including three and a half million persons with age range 35-64 years, of whom 550 000 were born abroad, from the database MigMed consisting of the whole Swedish population. Incidence rates and relative risks were estimated by indirect standardization and a proportional hazard model. RESULTS: The age-adjusted risk of coronary heart disease was higher in most foreign-born groups than in Swedes. For example, in nine of 12 male groups, the relative risks varied between 1.1 and 2.2, and in seven of 12 female groups, the relative risks varied between 1.4 and 2.5. When also adjusting for level of education and employment status, the risks were still high, but on a lower level. CONCLUSIONS: Foreign-born people possess an over-risk of cardiovascular or coronary heart disease(CVD/CHD) compared with Swedish-born persons, also when level of education and employment status are taken into account.     

C·肉毒杀鼠素(冻干剂)应用研究

目的为研究C·肉毒杀鼠索对杀灭达乌尔黄鼠(简称黄鼠)的大面积应用情况和对家畜、家禽的毒害作用,进行了C·肉毒杀鼠素的应用研究.方法大面积投毒采用ES-2药饵撒播机[1],间隔约80m进行条投.羊、鸡采用直接灌胃.结果大面积应用的灭鼠率为83.72%.对羊、鸡最高剂量分别为500万MLD、150万MLD,均未出现中毒现象.结论 C·肉毒杀鼠素是较为理想的草原大面积杀灭黄鼠的理想、首选药物.     

高龄老年高血压的临床研究进展

随着社会老龄化进程的加快,80岁以上高龄老人的绝对数量以及占总人口的比例均在增加,如何提高高龄老年高血压的防治水平备受关注。现试从高龄老年高血压的临床特点、治疗策略等方面的临床研究进展作一综述。     

中国老年性耳聋的研究与干预进展

老年性耳聋已成为影响我国老年人生活质量的最主要的慢性病之一。助听器是目前帮助听力损失的老年人克服交流障碍的主要手段。在我国,数字助听器已逐渐取代模拟助听器并且体现出了更好的效果。但是老年听力损失患者中使用助听器的比例仍然很小。人工耳蜗植入也已被应用在老年患者中。我国针对老年人的听力康复服务还有较长的路要走。     

糖尿病大鼠心室肌细胞钾通道的改变

目的研究糖尿病大鼠心室肌细胞钾通道的改变及增加葡萄糖代谢对其的作用。方法取体重150～200g的雄性SpragueDawley大鼠,腹腔注射链脲菌素(STZ)建立糖尿病模型,采用酶解法获得单个心室肌细胞,应用膜片钳全细胞记录技术记录钾电流。结果糖尿病大鼠心室肌细胞瞬间外向性钾流(Ito)密度较对照组显著降低[ 60mV时,分别为(15.90±1.19)pA/pF(n=25)和(28.55±0.97)pA/pF(n=12),P<0.001];分别用100nmol/L胰岛素及1.5mmol/L二氯乙酸在体外预处理心室肌细胞4～5h和3～4h使Ito密度恢复至对照组水平[ 60mV时,分别为(29.40±0.38)pA/pF(n=20)和(27.35±0.97)pA/pF(n=12)]。结论糖尿病大鼠心室肌细胞钾通道功能发生改变,增加葡萄糖代谢可逆转这一改变,提示葡萄糖代谢与Ito功能间存在一定关系。     

Sex Differences in Ethanol-induced Dopamine Release in Nucleus Accumbens and in Ethanol Consumption in Rats

In vivo microdialysis was used to examine changes in nucleus accumbens and striatal dopamine, dihydrophenylacetic acid (DO-PAC), and homovanillic acid (HVA) following acute administration of ethanol (0.0, 0.25, 0.5, 1.0, or 2.0 g/kg) in male and female Long-Evans rats. Following dialysis, rats were trained to bar-press for oral ethanol reinforcement. In nucleus accumbens, females showed significant increases in extracellular dopamine following 0.25 or 0.5 g/ kg ethanol, but did not show significant increases over baseline at the higher doses. Males showed slight increases in dopamine at the lower doses and decreased dopamine at 2.0 g/kg. In striatum, both sexes showed increased dopamine at the lower doses and decreased dopamine at 2.0 g/kg. There were slight increases in nucleus accumbens DOPAC and HVA at some doses in both sexes, but no changes in striatal metabolite levels. In addition to showing increased responsiveness to ethanol-induced mesolimbic dopamine stimulation, females consumed more ethanol than males during behavioral testing. The pattern of both greater ethanol-induced nucleus accumbens dopamine release and greater ethanol consumption in females supports the hypothesis that ethanol reward is mediated, at least in part, by the mesolimbic dopamine system.     

Dead in Bed Syndrome in Young Diabetic Patients in Norway

The incidence of unexplained deaths (‘dead in bed syndrome’) in Norwegian diabetic patients under the age of 40 was investigated during the period 1981–1990. During this 10-year period there were 240 deaths of all causes in the age group 0–39 years. Sixteen of these cases fulfilled the following criteria of the ‘dead in bed syndrome’: (1) patient found dead in an undisturbed bed; (2) patient observed to be in good health condition the day before; (3) no clinical evidence of late complications (except background retinopathy in two cases). Of the 16 cases ascertained, 10 were males and 6 females. The age range was 7–35 years, and the duration of diabetes varied between a few months and 26 years. Autopsy, performed in 13 cases, did not reveal any cause of death. Nine patients had been using insulin regimens with multiple daily doses. Twelve patients were reported as having had frequent episodes of hypoglycaemia, with nocturnal episodes in 10 cases. There was apparently an increasing incidence of unexplained deaths during the study period, with 12 of 16 cases occurring in the years 1988 to 1990.