绝经后抑郁症患者治疗前后性激素水平与临床疗效的相关性研究

目的 探讨绝经后抑郁症患者治疗前后性激素水平的变化及其与预后的相关性.方法 将30例绝经后抑郁症患者设为研究组,30名绝经后正常女性设为对照组;研究组均口服帕罗西汀治疗6周,于治疗前后检测性激素水平,同时采用汉密顿抑郁量表评定临床疗效;对照组于入组时检测性激素水平.结果 治疗后研究组促黄体生成素、促卵泡刺激素水平均较治疗前显著下降,雌二醇水平显著升高(P＜0.05).研究组治疗前促黄体生成素、促卵泡刺激素水平均显著高于对照组,雌二醇水平显著低于对照组(P＜0.01);治疗后促卵泡刺激素水平仍显著高于对照组(P＜0.05),雌二醇水平仍显著低于对照组(P＜0.05).研究组治疗有效者治疗前雌二醇水平显著高于治疗无效者(P＜0.01).研究组治疗前雌二醇水平与汉密顿抑郁量表评分呈显著负相关(R=-0.67,P＜0.01),治疗后与汉密顿抑郁量表减分率呈显著正相关(R=0.63,P＜0.01).结论 绝经后抑郁症患者治疗前后性激素水平有不同程度的变化,雌二醇、促卵泡刺激素、促黄体生成素水平的改变可能影响抑郁症状;其中雌二醇水平的变化可作为预测患者预后的一项指标.     

炔雌醇环丙孕酮片在治疗多囊卵巢综合征女性痤疮中的应用

目的探讨达英35在多囊卵巢综合征(PCOS)合并女性痤疮患者中的应用。方法选取PCOS合并痤疮患者65例,同期另择正常健康女性30例作为对照组。65例PCOS患者采用炔雌醇环丙孕酮片治疗。于治疗前及治疗后第3个和第6个周期末,记录多毛评分和痤疮评分;于早卵泡期及治疗后第3个月和第6个月末,测定血清总睾酮、黄体生成素、卵泡刺激素、空腹血糖、空腹胰岛素,计算黄体生成素/卵泡刺激素比值和胰岛素抵抗指数(HOMA-IR)。结果与治疗前比较,治疗后两时间点的多毛评分、痤疮评分、血清总睾酮和黄体生成素水平及黄体生成素/卵泡刺激素比值均显著降低。伴有胰岛素抵抗患者治疗后6个周期末的HOMA-IR水平明显高于治疗前。结论高雄激素血症和PCOS与成年女性痤疮有关,且是其长期不愈的重要原因。炔雌醇环丙孕酮片对此类痤疮有较好疗效。     

Hormonal and physical markers of puberty and their relationship to adolescent-typical novelty-directed behavior

The extent to which characteristic adolescent behaviors are associated with pubertal changes or driven by more general, puberty-independent developmental alterations is largely unknown. Using physiological and hormonal markers of puberty, this experiment characterized pubertal timing across adolescence and examined the relationships among these variables and novelty-directed behaviors. Males and females were tested for response to novelty at P28, P32, P36, P40, P44, P48, and P75, and examined for balano-preputial skinfold separation and sperm presence (males) or vaginal opening (females), followed by blood collection for hormonal assessments. Despite earlier pubertal maturation in females, with maturation generally completed by P36 in females and P44 in males, novelty-directed behavior peaked at P32 and P36 in both sexes, and was unrelated to pubertal measures. These data support the suggestion that the ontogenetic peak in this behavior during adolescence is not notably puberty dependent.     

妊娠4～9周孕妇血清雌二醇变化与妊娠结局的关系

目的探讨妊娠4～9周孕妇血清雌二醇（E2）变化与妊娠结局的关系。方法选择在本院就诊的妊娠4～9周的孕妇,根据孕妇妊娠结局分为正常妊娠组和胚胎停育组,正常妊娠组又根据有无复发性流产病史者分为两组,各组按孕周又分为6个亚组。采用化学发光分析法检测各组孕妇血清E2水平,并进行比较分析。结果正常妊娠组妊娠4～9周孕妇每周血清E2水平随妊娠周数增加而增加,有复发性流产病史的患者和无复发性流产的患者各孕周E2水平的变化差异无统计学意义（P〉0.05）;而胚胎停育组随孕周增加呈下降趋势。与正常妊娠组的相应孕周两两比较胚胎停育组各个孕周孕妇血清E2水平相应均数显著偏低（P〈0.05）。结论胚胎停育孕妇各孕周血清E2水平均显著下降,提示E2可能是维持早期妊娠的重要因素之一。     

Effects of estradiol-17beta on expression of mRNA for seven angiogenic factors and their receptors in the endometrium of ovariectomized (OVX) ewes

We have previously established an ovariectomized (OVX) ewe model to study how steroid removal and replacement affects uterine blood vessel and tissue growth. Using this model, endometrial expression of mRNA for 14 angiogenic factors (7 genes and their respective receptors) in caruncular (CAR) and intercaruncular (ICAR) endometrium were evaluated by quantitative real time RT-PCR at 0 (control), 2, 4, 8, 16, or 24 h after treating OVX ewes with an estradiol-17β (E2) implant. In CAR and ICAR, compared to 0 h, the mRNA expression of vascular endothelial growth factor (VEGF), VEGF receptor (R)1, soluble guanylate cyclase (GUCY1B3; the R for nitric oxide [NO]), hypoxia inducible factor (HIF) 1α, and placental growth factor (PIGF) increased by 4 h after E2-treatment, but basic fibroblast growth factor (FGF2), endothelial NO synthase (NOS3), angiopoietin (ANGPT)1, ANGPT2, ANGPT receptor Tie2 by 2 h after E2. Expression of mRNA for FGFR2IIIc was increased at 2 h by E2-treatment in ICAR, but not in CAR. By contrast, expression of neuropilin (NP) 1 mRNA was increased at 2 h in CAR, but not ICAR. The mRNA expression of VEGF, FGF2, HIF1α, and PIGF was positively correlated with mRNA expression of NOS3, VEGFR1, and Tie2 suggesting some E2-stimulated interactions between these factors in promoting blood vessel growth. Thus, several major angiogenic factors and their receptors are increased within hours after E2-treatment, which indicates that E2 plays a role in regulation of angiogenesis in the uterus. By using the OVX ewe model, we may begin to understand the molecular basis of E2 effects on angiogenesis in the endometrium and, eventually, how angiogenesis is regulated in normal versus pathological conditions.     

高效液相色谱法测定复方庚酸炔诺酮注射液的有关物质

 目的 建立复方庚酸炔诺酮注射液有关物质检查的方法。方法 采用HPLC梯度洗脱法,Phenomenex Gemini C₁₈柱（4.6 mm×250 mm,5 μm）,流动相A为水,流动相 B为乙腈,流速为1.0 mL·min^-1,检测波长220 nm,柱温35 ℃。结果 主成分庚酸炔诺酮和戊酸雌二醇与各有关物质分离度良好。已知杂质炔诺酮和雌二醇分别在5.02~45.2和0.505~4.55 μg·mL^-1内线性关系良好,相关系数分别为1.000 0（n=5）和0.999 2（n=5）,平均回收率（n=3）分别为99.4%和96.2%,RSD分别为0.9%和3.3%;庚酸炔诺酮和戊酸雌二醇自身对照溶液分别在2.42~121和0.242~12.1 μg·mL^-1内线性关系良好,相关系数均为1.000 0（n=6）;炔诺酮、雌二醇、庚酸炔诺酮和戊酸雌二醇的检测限分别为7.3、2.0、0.9和1.2 ng。结论 建立的HPLC能准确、灵敏、专属地测定复方庚酸炔诺酮注射液中的有关物质,经对不同生产日期的4批产品进行检验,本品有关物质的量与储存时间呈明显的相关性。     

国产左炔诺孕酮＋炔雌醇片与进口对照片溶出曲线对比

目的：国产左炔诺孕酮＋炔雌醇片与进口左炔诺孕酮＋炔雌醇片溶出曲线的对比。方法：本试验采用ZRS--6智能溶出试验仪,以5ug／g聚山梨酯80为溶出介质,分别测定了左炔诺孕酮＋炔雌醇进口对照片与国产片的溶出曲线。结果及结论：国产左炔诺孕酮＋炔雌醇片与进口左炔诺孕酮＋炔雌醇片在5ug／g聚山梨酯80中溶出完全,且两者溶出曲线基本一致。     

左归丸对大鼠卵泡发育与卵巢血管生成的影响

目的:探讨左归丸对大鼠卵巢卵泡发育与血管生成的影响.方法:将SD大鼠(160～170 g)随机分为空白对照组(A组)、结合雌激素组(B组)、左归丸成药低(C组)、高剂量组(D组)、左归丸浸膏低(E组)、高剂量组(F组),各组n=10.分别灌服蒸馏水20 g·kg-1、结合雌激素混悬液65μg·kg-1、左归丸混悬液1.875,5.625 g·kg-1、左归丸浸膏相当于生药11,33 g·kg-1,每日1次,连续15d.计数大鼠卵巢各级卵泡及黄体;计算生殖器官(卵巢、子宫及阴道)脏器指数;采取酶免疫分析法测定血清雌二醇(E2)水平.将大鼠随机分为空白对照组、结合雌激素组(65μg·kg-1)、左归丸成药组(5.625 g·kg-1)、左归丸浸膏组(相当于生药33 g·kg-1),各组n=6.应用墨汁灌注法观察卵巢血管.结果:D,F,B组均可增加大鼠窦状卵泡数(21.70±10.40,15.60±2.22,15.60±8.04)个及卵泡总数(32.10±11.57,25.30±5.06,29.10±18.62)个,B～F组均可增加大鼠卵巢指数(0.68±0.11,0.55±0.05,0.68±0.08,0.61±0.10,0.68±0.03),D～F,B组均可提高大鼠血清E2水平(86.92±5.05,68.98±9.19,87.16±10.37,87.39±12.81)ng·L-1,均P＜0.01或P＜0.05.结合雌激素组、左归丸成药组、左归丸浸膏组的卵巢血管密度和管腔明显增大.结合雌激素组、左归丸浸膏组组可增加卵巢小血管数(13.33±2.50,13.17±3.87)个,结合雌激素组、左归丸成药组、左归丸浸膏组均可增加大鼠卵巢大血管数(33.00±5.44,34.33±8.59,35.83±7.63)个及血管总数(46.33±7.82,45.00±10.84,49.33±11.11)个,P＜0.05或P＜0.01.结论:左归丸可促进160～170 g大鼠卵泡发育和卵巢血管生成,其促卵泡发育作用与提高雌激素水平、增加雌激素样效应及增加卵巢血管数有关.左归丸浸膏较成药丸剂作用更明显.     

屈螺酮炔雌醇片应用于人工流产术后的疗效观察

目的：探讨屈螺酮炔雌醇片口服避孕药（商品名：优思明）对减少人工流产术后阴道出血量、缩短出血时间、促进月经复潮和子宫内膜恢复的作用,对体重变化的影响以及预防宫腔黏连等术后并发症的疗效。方法：来我院进行人工流产术并自愿术后口服避孕药的65例女性列为试验组,随机选择同期人工流产的女性120例作为对照组。试验组术后即时口服益母草胶囊和屈螺酮炔雌醇片,对照组只服用益母草胶囊。随访3个月进行临床对比。结果：试验组术后阴道出血时间、月经复潮时间、子宫内膜的厚度和术后并发症等与对照组相比,均具有显著性差异（P〈0．05）。结论：人工流产术后即时服用屈螺酮炔雌醇片,对促进子宫内膜恢复、降低术后并发症发生率、恢复正常的月经周期具有较好的疗效,值得临床进一步推广。