辅助生殖技术对卵巢恶性和交界性肿瘤致病风险的研究进展

辅助生殖技术（ART）的开展解决了广大不孕不育夫妇的生育难题,对人类和社会发展具有积极的作用。但ART中常用的辅助生殖药物在理论上存在着诱发女性恶性肿瘤的风险。现综合分析1990年1月—2020年6月在Pubmed、EMBASE和Cochrane Library上发表的有关ART与卵巢癌和（或）交界性卵巢肿瘤（borderline ovarian tumors,BOT）相关性的临床研究42项,系统性阐述ART及不同的辅助生殖药物对卵巢癌和BOT的致病风险。研究结果显示,多数研究（27/42,64.3%）均认为ART并不增加卵巢癌和BOT的致病风险,但也有部分研究（15/42,35.7%）认为ART存在着诱发卵巢癌或BOT的潜在风险,尤其是近5年的研究（6/10,60%）对此结论多呈肯定态度。对于ART与卵巢癌和BOT之间的相关性,还需要长期、大样本的研究进行随访和评估。     

Male infertility and gonadotropin treatment: What can we learn from real-world data?

Gonadotropin therapy to treat specific male infertility disorders associated with hypogonadotropic hypogonadism is evidence-based and effective in restoring spermatogenesis and fertility. In contrast, its use to improve fertility in men with idiopathic oligozoospermia or nonobstructive azoospermia remains controversial, despite being widely practiced. The existence of two major inter-related pathways for spermatogenesis, including FSH and intratesticular testosterone, provides a rationale for empiric hormone stimulation therapy in both eugonadal and hypogonadal males with idiopathic oligozoospermia or nonobstructive azoospermia. Real-world data (RWD) on gonadotropin stimulating for these patient subsets, mainly using human chorionic gonadotropin and follicle-stimulating hormone, accumulated gradually, showing a positive therapeutic effect in some patients, translated by increased sperm production, sperm quality, and sperm retrieval rates. Although more evidence is needed, current insights from RWD research indicate that selected male infertility patients might be managed more effectively using gonadotropin therapy, with potential gains for all parties involved.     

The use of hormone stimulation in male infertility

Infertility affects 15% of couples worldwide and in approximately 50% of cases the cause is secondary to an abnormality of the sperm. However, treatment options for male infertility are limited and empirical use of hormone stimulation has been utilised. We review the contemporary data regarding the application of hormone stimulation to treat male infertility. There is strong evidence supporting the use of hormone stimulation in hypogonadotropic hypogonadism but there is inadequate evidence for all other indications.     

绝经后激素分泌改变引起脂代谢异常及运动干预对脂代谢异常调节的研究进展

绝经是女性必然经历的正常生理阶段，因为绝经后体内多种激素分泌水平发生改变，由此引发的代谢紊乱困扰着众多女性，脂代谢异常是女性绝经后常见问题之一。由于脂代谢异常发病形式隐匿往往不易受重视，其进一步发展可导致肥胖、心血管疾病、非酒精性脂肪肝等，严重危害了绝经后女性健康。运动干预是防控脂代谢异常的有效手段，本文总结了女性绝经后与脂代谢相关的雌二醇（E2）、促卵泡激素（FSH）的分泌变化及其对脂代谢的影响，探讨了不同运动方式对绝经后女性脂代谢异常的干预效果，并对绝经后激素分泌改变引起脂代谢异常的机制及运动调控机制进行了归纳，研究发现女性绝经前后E2、FSH激素水平的变化并不呈单一模式，这种变化通过多个机制共同作用引起的脂代谢异常可在不同运动方式干预后得到改善，从而为女性绝经后脂代谢异常的防治提供理论依据，提高绝经后女性的生活质量，降低心血管疾病的发生风险。