氟西汀对2型糖尿病合并抑郁症患者下丘脑-垂体肾上腺轴功能及临床疗效的影响

目的探讨氟西汀对 2型糖尿病合并抑郁症患者的下丘脑 垂体 肾上腺轴 (HPA)功能的影响及其临床意义。方法测定 98例 2型糖尿病患者和 3 4例正常对照组基础血皮质醇 (F ,0 8:0 0am、16:0 0pm)、小剂量地塞米松抑制试验 (DST)后血F、2 4h尿游离皮质醇 (UFC)。将 64例 2型糖尿病伴发抑郁症患者随机分成A组 (服用氟西汀组 ,3 2例 )和B组 (未服用氟西汀组 ,3 2例 )。予 6周治疗。分别于治疗前、后进行HAMD评分及代谢控制水平评估。结果 ( 1)血F( 0 8:0 0am、16:0 0pm)、2 4h尿UFC、DST脱抑制例数2型糖尿病患者较正常对照组增高 (P <0 .0 1) ,2型糖尿病伴抑郁症组 (DD组 )较无抑郁症组 (DM组 )增高(P <0 .0 5 ,P <0 .0 1)。 ( 2 )经 6周治疗后 ,服用氟西汀组 (A组 )较未服用氟西汀组 (B组 )糖皮质激素水平降低 (P <0 .0 1)、HAMD评分降低 (P <0 .0 1) ,糖脂代谢改善 (P <0 .0 5 ,P <0 .0 1)。 ( 3 ) 2 4h尿UFC与HbA1C呈正相关性 (r =0 .5 69,P <0 .0 1)、IR呈正相关 (r =0 .65 3 ,P <0 .0 1)、与HAMD评分呈正相关性 (r =0 .3 5 2 ,P <0 .0 5 )。结论 2型糖尿病及合并抑郁症患者HPA轴功能紊乱 ,加重了糖代谢紊乱和胰岛素抵抗 ;氟西汀干预治疗抑郁症可改善抑郁症和糖脂代谢。     

正常月经周期中血清瘦素与雌激素的关系

目的 :探索健康妇女正常月经周期中血清瘦素与雌激素的关系 .方法 :①对 18例月经规则妇女 (2 8± 1)d ,用放射免疫法分别在其月经第 1,7,14和 2 1d测定血清瘦素及性激素 (FSH ,E2 ,PRO ,T) .②对 19例不孕妇女 ,在受精前用FSH 2 2 5IU·d-1治疗后第 3d、第 5d用放免法测定其血清瘦素及雌激素浓度 .结果 :①血清瘦素在月经周期中的生理性变化 ,月经第 1d ,血清瘦素为 (5 .4 9± 1.0 8) μg·L-1,随着卵泡的发育成熟 ,瘦素水平逐渐升高 ,14d达高峰 (9.2 8± 1.87) μg·L-1,其差异有显著性 (P <0 .0 1) .②用FSH治疗 3,5d ,血清雌激素浓度和瘦素水平 [(89.0 8± 18.0 7)ng·L-1,(10 .99± 1.94 ) μg·L-13rdday],[(12 6 .2 6± 19.79)ng·L-1,(14 .78± 2 .0 0 ) μg·L-15thday]均较治疗前 [(5 8.5 9± 6 .4 0 )ng·L-1,(5 .4 6± 1.16 ) μg·L-1]明显升高 (P <0 .0 1) .结论 :月经周期中血清瘦素和雌激素的变化一致 ,雌激素参与瘦素分泌的调节或瘦素的分泌调节与雌激素有关     

良、恶性脑膜瘤性激素受体和外源凝集素受体的检测

采用 ABC 免疫组化技术对82例脑膜瘤活检组织(良性脑膜瘤67例、恶性脑膜瘤15例)进行了三种性激素受体和12种 LR 的测定.结果证实脑膜瘤是性激素的靶组织,ER阳性率74.4%,PR 阳性率75.6%。AR 阳性率29.3%.ER 阳性率与性别有关,女性高于男性;PR 阳性率与组织类型有关,脑膜内皮型阳性率最高,过渡型居中,而纤维母细胞型及砂粒体型阳性率较低;AR 阳性率与组织分化程度有关,恶性脑膜瘤中 AR 阳性率高于良性脑膜瘤中 AR 阳性率.这些结果为进一步探讨性激素受体在脑膜瘤的生物学行为上所起的作用及对脑膜瘤实施内分泌治疗提供理论依据.12种 LR 中只有 PSA 受体在良性脑膜瘤中的阳性率高于恶性脑膜瘤,故这一结果可作为良、恶性脑膜瘤诊断的依据.三种性激素受体与 LR 染色结果经配对卡方检验证明无相关性,因此 LR 的测定不能代替性激素受体的测定.     

A case of polycythemia vera complicated by chronic renal failure under hemodialysis requiring parathyroidectomy for secondary hyperparathyroidisim

A case of polycythemia vera complicated by chronic renal failure under maintenance hemodialysis requiring parathyroidectory (PTH) for secondary hyperparathyroidism (2° HPT) is reported. A 62 year old female presented with 75000 white blood cells (WBC)/μl, 703×10⁴ red blood cells (RBC)/μl, 23×10⁴ platelets (PLT)/μl, hyperuricemia and hypertension in 1970 and the diagnosis of polycythemia vera was made. Hemodialysis was started in October 1974 for chronic renal failure. Blood cells in peripheral blood rapidly decreased in number after the beginning of dialysis, reaching the level of 10000∼20000 WBC/μl, and 150∼250×10⁴RBC/μl. In August 1988, marked bone resorption in X-ray picture and high serum alkaline phosphatase and parathyroid hormone (PTH) noted along with 17400 WBC/μl, 370×10⁴RBC/μl and 35.9×10⁴PLT/μl. After subtotal PTX removing 3.21g parathyroid gland, serum PTH rapidly fell. At 3 months after PTX, WBC rose to 23600/μl, RBC 372×10⁴/μl and PLT 94.0×10⁴/μl. At 6 months, WBC was to 31000/μl, RBC 429×10⁴/μl and PLT 78.0×10⁴/μl, suggesting an inhibitory action of PTH on not only RBC, but also WBC and PLT.     

Stress-induced changes in behavior and function of the neurohormonal systems in monkeys differing in social rank

Research Institute of Experimental Pathology and Therapy, Sukhumi. (Presented by Academician of the Russian Academy of Medical Sciences B. A. Lapin.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 114, No. 11, pp. 457–459, November, 1992.     

隐睾患儿血清FSH、LH、T水平及其临床意义

目的研究隐睾患儿血中促卵泡激素(FSH)、促黄体激素(LID和睾酮(T)激素水平变化,探讨其临床意义及在隐睾症发病中的作用。方法应用化学发光免疫技术检测42例隐睾症和23例斜疝(对照组)患儿血清FSH、LH、T水平。结果单侧隐睾症组和斜疝组之间血清FSH、LH和T水平无显著性差异(P＞0．05)；(2)双侧隐睾组血清FSH水平高于斜疝组,差别有统计学意义(P＜0．05)；单侧隐睾症组血清FSH高于斜疝组,低于双侧隐睾症组,差别无统计学意义(P＞0．05)。结论(1)血清中性激素LH和T水平的变化在隐睾发生中并不起主要作用；(2)血清FSH水平的升高可能反映睾丸功能损害严重程度。     

Neuroactive Properties of Reproductive Steroids

Migraine is 3 times more common in postpubertal women than in men. Migraine is frequently exacerbated perimenstrually and commonly occurs exclusively at that time. It is often benefited by pregnancy and menopause. Estrogen withdrawal has been implicated as a mechanism for triggering migraines. The mechanism, however, is not well understood. Reproductive steroids have neuroactive properties that can modulate neuronal morphology and physiology. Increasing evidence suggests that circulating reproductive steroid levels regulate the balance of neuroexcitatory and neuroinhibitory activities in some brain regions by influencing synaptic plasticity. Estrogen has neuroexcitatory, whereas progesterone has neuroinhibitory, effects in most preclinical and clinical models. Several neurotransmitter systems that are implicated in migraine vary with reproductive steroid levels during the reproductive cycle. Estrogen stabilization may provide effective treatment in susceptible women, especially for catamenially exacerbated migraine.     

旋转强恒磁场对SD大鼠骨骼生长发育及相关激素的影响

目的探讨旋转强恒磁场（RCSMF）对SD大鼠的骨骼生长发育及相关激素的影响，为RCSMF促进人体增高的临床应用奠定基础。方法取25日龄的SD大鼠置RCSMF下，1．5h／d。每5天取血检测大鼠生长激素（GH）、类胰岛素生长因子（IGF-Ⅰ）、雌激素（E2）等与骨骼发育相关的激素，同时测量每组大鼠的身长、体重和尾长，并用骨形态计量学方法研究RCSMF对大鼠骨组织形态学和动态学参数的影响。结果RCSMF处理后大鼠的身长[实验组（25．28±0．41）cm。对照组（24．05±0．35）cm；P〈0．01]、体重[实验组（445．90±16．88）g，对照组（382．22±12．78）g；P〈0．01]、胫骨长[实验组（3．89±0．13）cm，对照组（3．66±0．10）cm；P〈0．01]和股骨长[实验组（3．65±0．08）cm，对照组（3．51±0．06）cm；P〈0．01]，上述多项参数以及骨骺板等相关形态计量学数据实验组明显高于对照组。回归分析身长与相关激素的关系显示：大鼠身长与GH、IGF—I和E2有显著相关性。结论RCSMF有促进骨骼生长发育的作用，其作用机理是通过刺激与骨骼生长发育相关激素的生成、释放，并影响软骨细胞的增殖功能来完成的。     

Evaluation of local cerebral glucose utilization and the permeability of the blood-brain barrier in the genetically epilepsy-prone rat

Summary The genetically epileptic-prone rat (GEPR) is a valuable model for the study of gene-linked abnormalities involved in epilepsy. In comparison with normal Sprague-Dawley controls, we found, in GEPRs, a marked depression in local cerebral glucose utilization, widespread throughout the brain. This depression was accompanied by a significant increase of blood-brain barrier permeability and a reduction in regional blood volume. Finally GEPRs showed lower plasma levels of total triiodothyronine than normal controls. One can speculate that alterations in cerebral metabolism and microvascular regulation and thyroid hormone imbalance may be gene-linked factors involved in seizure susceptibility.