长期高温高强度训练对武警阅兵队员血清睾酮与皮质醇的影响

目的研究长期高温、高强度训练对武警阅兵战士血清睾酮(T)和皮质醇(C)的影响。方法用酶免法测定长期在高温、高强度下训练的武警阅兵战士血清睾酮和皮质醇水平,计算睾酮/皮质醇比值(T/C),以接受常规训练的武警战士作为对照。结果阅兵组血清睾酮平均(17.3±6.1)nmol/L,显著低于对照组(22.0±8.9)nmol/L,差异有统计学意义(P<0.05);阅兵组血清皮质醇平均(407.0±127.4)nmol/L,显著低于对照组(530.8±206.7)nmol/L,差异有统计学意义(P<0.01);而阅兵组T/C值为0.048,与对照组0.05比较,差异无统计学意义(P=0.44)。结论长期高温、高强度训练导致武警阅兵战士血清睾酮水平和血清皮质醇水平下降,T/C值在阅兵组与对照组无统计学差别,说明阅兵组训练强度合适。     

Assessment of the follicular cortisol:cortisone ratio.

Cortisol and cortisone concentrations in serum and follicular fluid (FF) from women undergoing in-vitro fertilization (IVF) treatment were monitored. Four groups were included: group 1, women in their natural menstrual cycle having an endogenous mid-cycle surge of gonadotrophins; group 2, women in their natural menstrual cycle receiving human chorionic gonadotrophin (HCG) for ovulation induction; group 3, women receiving exogenous gonadotrophins for ovarian stimulation and HCG for ovulation induction; and group 4, women receiving exogenous gonadotrophins for ovarian stimulation, follicles being aspirated immediately before administration of HCG. In this study, 12 follicles contained oocytes which resulted in clinical pregnancy after IVF. Cortisone concentrations were significantly higher in FF compared with that of matched serum samples, while the opposite was observed for cortisol, resulting in cortisol:cortisone ratios being significantly lower in FF compared with serum. FF from group 4 showed significantly higher cortisone concentrations than FF from each of the other three groups. FF from group 1 showed significantly higher cortisone concentrations and significantly lower cortisol:cortisone ratios in comparison with groups 2 and 3. None of the observed parameters pinpointed any of the follicles containing oocytes which resulted in a clinical pregnancy. The intrafollicular concentrations of cortisol and cortisone suggest that pre-ovulatory follicles actively convert cortisol to cortisone. Neither FF concentrations of cortisol and cortisone nor the cortisol:cortisone ratio seem to reflect implantation potential of the derived pre-embryos.     

实验性兔角膜新生血管的防治研究

为研究角膜新生血管的防治疗法，用角膜缝线方法，诱导１２只家兔２４只眼角膜新生血管形成。缝线后的第３ｄ，１２只家兔随机分为３组，将不同药物分别注射于结膜下，观察每眼角膜新生血管生长情况。结果：平阳霉素（０．５ｍｇ）组新生血管的长度（ｘ±ｓｘ）为（２．８９±０．０３）ｍｍ，较对照组（４．８９±０．０２）ｍｍ短，但差异无显著意义（Ｐ＞０．０５）；肝素（２５００Ｕ）加可的松（１２．５ｍｇ）组新生血管的长度为（２．０４±０．０４）ｍｍ，明显短于对照组，差异有非常显著意义（Ｐ＜０．０１）。结果表明，肝素加可的松混合液结膜下注射防治兔角膜新生血管的作用优于平阳霉素。     

四环素可的松治疗难治性根尖周炎的疗效观察

目的：探讨四环素可的松眼膏治疗难治性根尖周炎的临床疗效.方法：采用随机分组对照研究,108颗难治性根尖周炎患牙分为对照组：52颗患牙根管消毒放置樟脑酚棉捻;研究组：56颗患牙根管导入四环素可的松眼膏至根尖孔,有窦道者则搔刮窦道并放置四环素可的松眼膏.记录两组患牙封药前后的临床表现,并进行统计学分析.结果：研究组有效率为83.93%;对照组有效率为61.54%.两组差异有统计学意义（P〈0.05）.结论：四环素可的松眼膏治疗难治性根尖周炎效果良好,值得推广应用.     

Interventional CT and MRI combined with microendoscopy for low back pain therapy

Summary

Acute and chronic back pain is the second most significant medical problem world-wide. Microinvasive CT-guided treatments of the spine are routine in our department. For this study, newly-developed procedures in an open 0.064 T and 0.2 T magnetic resonance imaging (MRI) scanner were compared with interventional CT. 340 patients who underwent microtherapeutic treatment took part in the study: 80 had percutaneous laser nucleotomies (PLNT), 100 had facet joint and 100 periradicular therapies (PRT); another 60 patients had ilio-sacral joint infiltrations. For PLNT a Neodymium YAG laser was used; for scar tissue treatment a Holmium YAG laser was used; for the other treatments, local anesthesia and cortisone, and 1.0 cm³ 50–96% ethanol (used for denervation in treatment of chronic facet joint pain) were instilled. 100 endoscopic treatments with systems 0.29–1.8 mm in diameter were undertaken: 20 on the facet joints, 80 inside the foramen intervertebrae, before and inside the disc after laser nucleotomy. Before treatment, 340 patients had a pain score of 70–100 on a visual analogue scale (VAS). The average pain score before therapy was 86%, after treatment it decreased to 7% (6 month follow-up). Neurologic deficits improved in 87% of cases after endoscopic discectomy (73% at follow-up). In MRI open access allows near real-time guidance of instruments. But the last 3.5 mm at the tip of the instruments is not easy to define. Interventional MRI is a routine technique in low risk areas, as in facet and ilio-sacral joints. CT-guidance is now the standard technique. In the future, endoscopes, drugs, lasers, RF-probes, cryosticks and mechanical instruments will be guided inside tomographic scanners for routine spinal work.     

烧伤患者的焦虑抑郁症状与血浆皮质醇水平的关系

目的探讨烧伤患者的焦虑抑郁症状与血浆皮质醇水平的关系。方法以烧伤患者33例为研究组,应用汉密顿抑郁量表（HAMD）和汉密顿焦虑量表（HAMA）为工具,于入院后0周、1周末和4周末分别评定烧伤患者的焦虑抑郁症状,并同步测定血浆皮质醇水平,分析焦虑抑郁症状量表分与血浆皮质醇水平的关系,并与本院30例体检者作对照。结果研究组的HAMD、HAMA总分在烧伤急性期（0周和1周末）均显著升高（P〈0．01）,好转后恢复至正常水平。与对照组比较,研究组的血浆皮质醇水平在急性期显著升高（P〈0．01）,随着烧伤的改善而恢复正常。研究组急性期（0周与1周末之间）血浆皮质醇水平的变化与HAMD、HAMA总分的变化呈正相关。结论烧伤患者在急性期存在不同程度的焦虑抑郁情绪,伴血浆皮质醇水平升高,此期需给予相应的药物治疗和心理干预。     

Diurnal excretion of urinary cortisol, cortisone, and cortisol metabolites in chronic fatigue syndrome

OBJECTIVE: The aim of this study was to obtain comprehensive information on basal hypothalamic-pituitary-adrenal (HPA) axis activity in chronic fatigue syndrome (CFS) patients who were not affected by medication or comorbid psychiatric disorder likely to influence the HPA axis. METHOD: Steroid analysis of urine collections from 0600 to 2100 h at 3-h intervals in CFS patients and in controls. RESULTS: Urinary free cortisol and cortisone concentrations showed a significant normal diurnal rhythm, but levels were lower across the cycle in CFS. In contrast, while urinary cortisol metabolites also showed a normal diurnal rhythm, levels were not significantly different between the CFS and controls at any time. Derived metabolite ratios were similar in both groups. CONCLUSION: This study provides further evidence for reduced basal HPA axis function in patients with CFS, based on lower free cortisol and cortisone levels, but this is not corroborated by cortisol metabolite data. The difference between these measures cannot be explained by an altered timing of the diurnal rhythm.     

Sexual differentiation of offspring of mothers treated with cortisone during pregnancy

Treatment of pregnant rats with hydrocortisone (1.5 or 3.0 mg) from Day 14 after conception until birth resulted in shortened anogenital distance and lowered testis weight in male offspring. No changes were found in female anogenital distance. It was concluded that corticosteroids, like stress, during pregnancy causes demasculinization of the male offspring     

Infertility caused by Antispermatozoal Antibodies in the Male Experience from an Intermittent High Dose Cortisone Regimen

Seventeen infertile male patients with antispermatozoal antibodies in seminal plasma and/or serum were treated with methylprednisolone, 48-96 mg daily for one week every other month in synchrony with the partner's menstrual cycles. Three to six treatment courses were given. One patient with draw from further treatment because of mental disturbance during the first cycle. Seminal plasma titres were affected more than titres in serum by the treatment. In the 16 couples completing treatment at least one pregnancy was achieved in six. Children were born to five of them. The observed pregnancy rate is similar to that previously reported. Risks of the treatment and safety precautions are discussed.