68例女性甲状腺功能异常的性激素检测分析

目的:研究女性甲状腺功能减退症(甲减)及甲状腺功能亢进症(Graves病,GD)患者是否存在性激素水平失衡,观察甲状腺功能异常患者性激素的水平。方法:采用放射免疫法测定研究对象的卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(TT)、雌二醇(E2)水平,采用硫酸铵沉淀法测定血清性激素结合球蛋白结合容量(SHBG)。结果:甲减组与对照组TT为(1.70±0.60)ng/ml vs(2.40±0.20)ng/ml,E2为(0.08±0.01)pg/ml vs(0.13±0.03)pg/ml。甲减患者组血清TT、E2值较对照组降低,差异有统计学意义(P<0.05)。甲减组与对照组的FSH分别为(18.12±1.30)mIU/L vs(10.8±1.40)mIU/L,LH为(32.89±21.64)mIU/L vs(10.20±1.10)mIU/L,甲减组FSH、LH较对照组明显升高,差异有显著统计学意义(P<0.05)。甲亢组与对照组FSH为(15.20±1.10)mIU/L vs(10.80±1.40)mIU/L,TT为(4.20±0.30)ng/ml vs(2.60±0.30)ng/ml,甲亢组FSH、TT较对照组升高,差异均有统计学意义(P<0.05)。甲亢组与对照组LH为(18.30±1.70)mIU/L vs(10.20±1.10)mIU/L,E2为(0.29±0.02)pg/ml vs(0.13±0.03)pg/ml,甲亢组LH、E2较对照组明显升高;差异有显著统计学意义(P<0.05);SHBG的改变均有显著统计学意义(P<0.05)。结论:女性甲状腺功能异常容易发生性激素水平紊乱,对诊治有重要意义。     

妊娠期糖耐量异常患者血清E2、P、PRL水平变化及其与瘦素水平的关系

目的探讨妊娠期糖耐量异常患者雌二醇(E2)、孕酮(P)、催乳素(PRL)水平变化及与瘦素的相关性。方法采用磁性分离酶联免疫吸附法测定30例正常妊娠、30例GIGT和15例GDM孕妇血清E2、P、PRL水平。采用放射免疫法测定其瘦素水平。结果(1)GDM组、GIGT组、NGT组血清E2水平分别为(21 660.33±5 352.01)pg/ml、(16 216.07±5 751.15)pg/ml、(14 525.71±4 268.39)pg/ml,各组间E2水平差异有统计学意义(P<0.005)。(2)GDM组、GIGT组、NGT组血清孕酮水平分别为(197.79±31.36)ng/ml、(158.86±14.98)ng/ml、(134.10±26.52)ng/ml,各组间孕酮水平差异有统计学意义(P<0.001)。(3)GDM组、GIGT组、NGT组血清PRL水平分别为(5 346.50±1 112.51)μIU/ml、(4 611.78±1 508.36)μIU/ml、(4 070.97±505.39)μIU/ml,各组间PRL水平有统计学意义(P<0.005)。(4)瘦素只与孕酮相关(相关系数0.321,P<0.01),与PRL、E2无统计学意义(P>0.05)。结论GIGT及GDM患者血清E2、孕酮、PRL水平与对照组比较显著升高,瘦素与孕酮水平相关。     

闭经患者血清性激素检测的临床价值

目的 探讨闭经患者血清性激素检测的临床意义.方法 应用化学发光免疫分析方法对50例闭经患者进行血清促黄体生成激素(LH)、促卵泡生成激素(FSH)、雌二醇(E2)、泌乳素(PRL)、孕酮(P)、睾酮(T)含量测定.结果 闭经组FSH、LH、PRL、E2含量[(12.10±10.76) mU/m、(12.20±8.11)mU/m、(40.11±23.45)ng/ml、(43.33±14.58)pg/ml]与对照组[(7.01±1.59) mU/m、(4.89±1.90)mU/m、(15.01±5.03)ng/ml、(52.79±8.91)pg/ml]比较有明显的差异 (t= 2.211、2.324、2.401、2.204,P均<0.05);50例闭经患者性激素一项指标异常者5例,两项指标异常者3例,三项以上指标异常者2例.结论 闭经患者血清性激素水平检测具有重要的临床意义,可为闭经患者的诊治提供重要的参考价值.     

不孕症患者血清性激素6项检测应用分析

目的:分析6项血清性激素在女性不孕症患者中检测价值。方法:选取女性不孕症患者100例作为实验组,选取同时期100例健康体检者作为对照组,检测并记录两组孕酮(PRGE)、黄体生成素(LH)、睾酮(T)、促卵泡生成素(FSH)、雌二醇(E2)、泌乳素(PRL),比较两组差异。结果:比较两组LH、FSH、PRL,差异具有统计意义[(24.06±12.06)mIU/mlVS(8.99±2.42)mIU/ml,(22.21±13.77)mIU/mlVS(8.91±2.79)mIU/ml,(26.74±19.57)ng/mlVS(10.23±3.45)ng/ml,P0.05]。结论:不孕症患者体内内分泌情况可通过血清性激素LH、FSH、PRL反应,血清性激素水平变化可为女性不孕症的诊断及治疗提供临床依据。     

血清LH、FSH、E2、T、P、PRL在不孕症患者中的表达及意义

目的 观察不孕症患者血清促黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、睾酮(T)、孕酮(P)、泌乳素(PRL)表达情况,并分析血清性激素六项预测不孕症发生风险的价值.方法 选取2018年10月至2019年12月于本院就诊的42例不孕症患者为作为观察组,选取同期于本院体检的33名健康体检者为对照组,均为女性,于月卵泡期取两组清晨空腹肘静脉血测定血清LH、FSH、E2、T、P、PRL水平,比较并分析性激素六项水平单独及联合检测对不孕症的诊断效能.结果 观察组LH、FSH、T、PRL水平均高于对照组,E2、P水平均低于对照组,差异有统计学意义(P<0.05);通过绘制ROC曲线得知,LH、FSH、E2、T、P、PRL对不孕症诊断截断值分别为14.15 mIU/mL、10.26 mIU/mL、25.45 pg/mL、0.98 ng/mL、0.21 ng/mL、30.26 ng/mL;联合检测AUC值、灵敏度均高于LH、FSH、E2、T、P、PRL各项单一检测.结论 LH、FSH、E2、T、P、PRL联合检测对不孕症诊断具有较高的诊断价值,可为临床诊断提供有效指导.     

术后辅助化疗对绝经前乳腺癌患者性激素和月经周期的影响

目的观察绝经前乳腺癌患者术后辅助化疗对其性激素和月经周期的影响,为临床选择综合治疗方案提供参考。方法应用回顾性分析及统计学方法,将97例绝经前乳腺癌患者按年龄不同分成3组,Ⅰ组:12例,年龄≤30岁;Ⅱ组:34例,年龄在31～40岁之间;Ⅲ组:51例,年龄≥41岁。分析不同组别在化疗过程中外周血血清雌激素(Eestrogen,E2)、孕激素(Progestin,P)、总睾酮(Testosterone,T)水平及其月经周期的变化。结果患者第一次接受化疗前,Ⅰ组患者血清E2、P、T浓度分别为:(283.73±53.12)pg/ml、(13.98±5.67)ng/ml、(48.64±16.73)ng/dl;Ⅱ组分别为:(278.86±59.36)pg/ml、(13.01±6.21)ng/ml、(46.32±17.09)ng/dl;Ⅲ组分别为:(243.11±90.12)pg/ml、(14.01±6.45)ng/ml、(43.89±18.88)ng/dl,各组E2、P或T间差异没有统计学意义(P值均>0.05)。随着患者接受化疗次数的增加,其血清中E2、P浓度在不同周期间差异存在统计学意义(P值均<0.01),即随着化疗周期的增加E2、P浓度逐渐降低;总睾酮(T)浓度在不同化疗周期间差异没有统计学意义(P值均>0.05),即T并没有随着化疗周期的增加而发生改变。化疗周期结束后,患者发生闭经率为41.2%,未闭经组E2、P、T浓度分别为:(53.66±37.91)pg/ml、(5.34±4.22)ng/ml、(43.32±22.04)ng/dl;闭经组分别为:(12.21±5.64)pg/ml、(0.5±0.2)ng/ml、(103.2±29.88)ng/dl,两组E2、P或T间存在差异,差异有统计学意义(P值均<0.01),即化疗诱导闭经后,患者血清E2、P浓度明显降低,血清T浓度显著升高。不同年龄组间闭经发生率及发生时间不同,患者年龄与化疗诱导的闭经发生率呈强正线性相关(r=1,P=0.016),年龄越大的患者接受化疗后,其发生的闭经可能性越大。患者年龄与闭经发生的时间呈强负直线相关(r=-0.99,P=0.031),患者年龄越大,其在化疗期间发生闭经的时间越早。结论绝经前乳腺癌患者术后接受辅助性化疗后,其血清E2、P浓度降低,T浓度反馈性增高,最终可引起患者闭经。     

不孕者增生晚期子宫内膜厚度与ERα和妊娠的关系

目的：探讨不孕患者增生晚期子宫内膜厚度（EMT）与雌激素受体α（ERα）和妊娠关系。方法选取收治的不孕患者92例作为研究对象。根据B超检查EMT结果不同将患者分为观察组（40例）和对照组（52例）。对患者进行性激素检查、EMT测定、不孕症治疗、ERα测定。观察2组患者EMT、性激素水平、ERα等相关指标，观察临床妊娠情况。结果观察组妊娠率为15.00%（6/40），对照组妊娠率为15.38%（8/52），差异无统计学意义。观察组EMT（5.06±0.52）mm、子宫内膜ERα水平（2.66±0.17）低于对照组（9.53±1.88）mm、（3.49±0.08）分，差异有统计学意义（P＜0.05）。2组患者E2、P、FSH、LH、PRL、T水平比较[（279.33±12.77) vs (295.04±13.92）pg/mL、（0.74±0.18) vs (0.72±0.17）ng/mL、（7.14±0.36) vs (7.33±0.93） mIU/mL、（8.47±2.55) vs (7.94±1.64）mIU/mL、（12.25±4.16) vs (13.48±3.33）ng/mL、（0.61±0.09) vs (0.69±0.28）ng/mL]，差异无统计学意义。经Pearson相关性分析，EMT与性激素水平、妊娠率无显著相关性，与ERα呈显著正相关（P＜0.05）。结论不孕患者增生晚期EMT与ERα呈正相关，与妊娠率、性激素水平无显著相关性。     

比索洛尔联合胰岛素增敏剂治疗对PCOS患者内分泌功能的影响

目的：探讨比索洛尔联合胰岛素增敏剂治疗对多囊卵巢综合征(PCOS)患者内分泌功能的影响。方法选择2011年8月至2014年8月我院内分泌科收治的60例PCOS患者,根据随机数表法将60例患者分为观察组(n=30)和对照组(n=30),对照组接受胰岛素增敏剂吡格列酮治疗,观察组患者接受比索洛尔联合吡格列酮治疗,比较两组患者治疗前后的空腹胰岛素(FIN)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、雌二醇(E2)、睾酮(T)、孕酮(PRGE)、垂体泌乳素(PRL)、性激素结合蛋白(SHBG)、皮质酮(Cor)、促肾上腺皮质激素(ACTH)、肾上腺皮质激素释放激素(CRH)、促性腺激素释放激素(CnRH)、环磷酸腺苷和环磷酸鸟苷的变化,并对疗效进行评价。结果治疗后,观察组患者的FIN [(18.5±3.9) mIU/L vs (26.3±4.7) mIU/L]、FPG [(7.13±1.4) mmol/L vs (4.72±1.7) mmol/L]、HOMA-IR [(0.65±0.13) vs (0.42±0.19)]、HOMA-β[(2.45±0.47) vs (1.69±0.14)]、E2[(56.9±8.7) pg/mL vs (46.9±10.5) pg/mL]、T [(58.5±4.2) ng/dL vs (39.6±6.7) ng/dL]、PRGE [(0.69±0.21) pg/mL vs (0.52±0.17) pg/mL]、PRL [(17.5±5.3) pg/mL vs (13.2±4.7) pg/mL]和环磷酸腺苷水平[(26.9±3.5) pmol/L vs (21.2±2.4) pmol/L]较治疗前均明显降低(P<0.05),SHBG [(18.5±3.9) nmol/L vs (26.3±4.7) nmol/L]、Cor [(18.5±3.9) ng/mL vs (26.3±4.7) ng/mL]、ACTH [(18.5±3.9) ng/mL vs (26.3±4.7) ng/mL]、CRH [(53.7±6.4) pg/mL vs (61.3±7.2) pg/mL]和环磷酸鸟苷的水平[(25.6±4.9) pmol/L vs (27.1±1.8) pmol/L]较治疗前均明显升高,差异均有统计学意义(P<0.05);治疗后,对照组患者的FIN [(25.9±3.7) mIU/L vs (18.5±3.9) mIU/L]、FPG [(7.09±0.93) mmol/L vs (5.52±1.86) mmol/L]、HOMA-IR [(0.67±0.14) vs (0.45±0.11)]、HOMA-β[(2.39±0.96) vs (2.08±0.33)]、E2[(57.8±6.4) pg/mL vs (46.9±10.5) pg/mL]、T [(59.6±5.5) ng/dL vs (45.8±9.1) ng/dL]、PRGE [(0.67±0.19) pg/mL vs (0.53±0.15) pg/mL]和PRL [(17.4±3.3) pg/mL vs (14.2±5.6) pg/mL]较治疗前均明显降低,SHBG [(84.3±15.8) nmol/L vs (131.9±30.1) nmol/L]水平较治疗前明显升高,差异均有统计学意义(P<0.05),而Cor、ACTH、CRH、环磷酸腺苷水平和环磷酸鸟苷水平较治疗前均无明显变化(P>0.05);观察组患者的治疗总有效率为93.33%,明显高于对照组的66.67%,差异有统计学意义(P<0.05)。结论比索洛尔联合胰岛素增敏剂吡格列酮治疗PCOS可明显改善患者机体的内分泌环境,提高患者的治疗效果。     

性激素水平与痤疮中医分型的关系研究

目的:探讨性激素水平与痤疮中医分型的关系。方法:采用放射免疫双抗法进行血清血清黄体生成素(LH)、卵泡刺激素(FSH)、雌激素(E2)、睾酮(T)、血清泌乳素(PRL)水平的检测。结果:女性肝郁气滞型痤疮患者的血清性激素水平与女性湿热内蕴型痤疮患者血清性激素水平比较,LH差异无显著性(P>0.05),FSH、E2T、PRL、LH/FSH差异均有显著性(P<0.01)。男性肝郁气滞型痤疮患者血清性激素水平与男性湿热内蕴型痤疮患者血清水平进行比较,血清T、PRL差异有显著性(P<0.05)。结论:性激素水平与痤疮中西分型有关,PRL、LH/FSH是肝郁气滞型痤疮患者中西分型的微观物质基础,而T是湿热内蕴型痤疮患者中医分型的微观物质基础。     

新生儿缺血缺氧性脑病血清和脑脊液神经功能及白细胞介素表达变化

目的 探究血清及脑脊液神经功能及白细胞介素在新生儿缺血缺氧性脑病表达变化情况,为疾病的诊断与治疗提供参考依据.方法 选取驻马店市中心医院2016年1月至2018年3月期间治疗的68例缺血缺氧性脑病新生儿为观察组,同时期的68例无脑病新生儿为对照组.比较两组不同分期的血清及脑脊液神经功能及白细胞介素表达水平,同时比较观察组急性期时不同严重程度者的血清及脑脊液神经功能及白细胞介素表达水平.结果 观察组急性期血清及脑脊液神经功能及白细胞介素表达水平为(38.96±4.63)ng/L、(0.39±0.09)μg/L、(0.52±0.10)μg/L、(50.72±5.77)ng/L、(0.69±0.15)μg/L、(0.70±0.13)μg/L及(9.46±1.25)pg/ml、(10.27±1.54)pg/ml、(2.89±0.32)pg/ml、(10.72±1.46)pg/ml、(11.46±1.62)pg/ml、(3.17±0.40)pg/ml,恢复期的血清及脑脊液神经功能及白细胞介素表达水平分别为(20.63±2.78)ng/L、(0.23±0.05)μg/L、(0.37±0.06)μg/L、(35.26±3.78)ng/L、(0.40±0.10)μg/L、(0.43±0.08)μg/L及(5.67±0.87)pg/ml、(7.20±0.99)pg/ml、(1.84±0.24)pg/ml、(6.42±0.98)pg/ml、(8.45±1.10)pg/ml、(2.20±0.26)pg/ml,均高于对照组(t=47.732,25.938,21.325,52.962,25.875,29.049,38.855,32.925,47.510,42.978,41.142,46.798,P均=0.000),观察组急性期时不同严重程度者的血清及脑脊液神经功能及白细胞介素表达水平比较,差异有统计学意义(P<0.05).结论 血清及脑脊液神经功能及白细胞介素在缺血缺氧性脑病新生儿呈现高表达状态,且不同分期与严重程度患儿的表达差异明显,对于本病新生儿的诊断与治疗具有指导意义.     

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…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

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.