短期使用二丙酸倍氯米松鼻喷雾剂对肾上腺皮质功能的影响

目的研究鼻用二丙酸倍氯米松(beclometh-asonedipropionate,BDP)对变应性鼻炎患者肾上腺皮质功能的影响。方法32例变应性鼻炎患者接受4周BDP(200μg/次,2次/日)喷鼻治疗后,应用放射免疫测定法检测其晨血皮质醇浓度,同时检测31例健康人的晨血皮质醇浓度作为对照。结果接受4周BDP治疗后变应性鼻炎患者与健康人的晨血皮质醇浓度分别为(388.9±146.1)nmol/L和(418.9±174.9)nmol/L,未见显著性差异(P>0.05)。结论治疗剂量(400μg/天)下持续使用4周BDP没有导致变应性鼻炎患者肾上腺皮质功能抑制。     

Effect of Non-Sex Hormones on Neuronal Excitability, Seizures, and the Electroencephalogram

Summary: : Several of the non-sex hormones have been found to be useful in the treatment of seizures. These hormones have an effect on seizures, and seizures have an effect on these hormones. Adrenocorticotropic hormone (ACTH) and corticosteroid drugs have been found to be useful in the treatment of infantile spasms and other seizure disorders. Unfortunately, there is no clear consensus regarding superiority of ACTH versus prednisone in regard to efficacy and long-term benefits, dosage, or duration of treatment. There is also considerable debate regarding reasons why ACTH and prednisone are useful in infantile spasms, their mechanism of action, and their long-term effects on brain development. Thyrotropin-releasing hormone also has been used in the treatment of infantile spasms and other seizure types in children, with modest success. As with ACTH and prednisone, the mechanisms of action remain unclear.     

Androgen influence on exocrine pancreatic cancer

Since the discovery of the first gastrointestinal hormones it has been intriguing to think that these defined chemical messengers may also influence the growth of tumors. Today, treatment with sex-hormones is well documented—and used in clinical practice—in prostatic (1,2), breast (3), endo-metrial, and ovarian carcinoma(4). Hormonal therapy (progesterone) has also been tried with some success in renal carcinoma(5,6). Nevertheless, cancers of the gastrointestinal tract—colorectal, liver, stomach, and pancreatic carcinoma, which constitute 25 percent of all malignancies in Scandinavia—are only treated by other means, mainly surgery, although there is substantial evidence today that these tumors can also be influenced by hormones.     

The Effect of Seizures on Hormones

Summary: Serum prolactin (HPR) levels are influenced by waking and sleep states, as reflected by surges in serum concentrations during daytime naps and nocturnal sleep. Other physiological causes of hyperprolactinemia include sexual activity, pregnancy, and lactation. Drugs may stimulate or inhibit HPR secretion. Pathological causes for HPR secretion include destructive lesions of the hypothalamus, prolactin-secreting neoplasms of the pituitary gland, lesions of the spinal cord, and occasionally Parkinson's disease. The most predictable postictal changes are increased serum Cortisol levels and hyperprolactinemia. Serum HPR rises after virtually all generalized tonic-clonic seizures, most complex partial seizures, and some simple partial seizures. Absence and myoclonic seizures do not affect serum HPR levels. Repeated epileptic seizures and electroconvulsive therapy treatments produce successively less marked rises in serum HPR. The postictal elevation of serum Cortisol has a longer latency than for HPR and follows an earlier rise in serum ACTH. Other postictal hormonal changes are much more variable. Because of the normal diurnal variation in serum Cortisol levels and the relative delay in the postictal elevation of serum Cortisol, HPR is more useful as a diagnostic measure of epileptic seizures. This application of HPR requires an understanding of other factors that influence serum HPR and the use of baseline serum HPR levels for comparison. HPR data must be correlated with behavioral and electroencephalographic events.     

Neural Regulation of Pituitary Function

Summary: : Neural regulation of pituitary function can serve as a basis for understanding endocrine and reproduction dysfunction in epilepsy. Because the pituitary gland is the final common pathway for central neural modulation of the endocrine system, hypothalamic control of pituitary function is important. The syndrome of functional hypothalamic amenorrhea is an example of stress-induced alteration in endocrine function and may serve as a model to suggest the impact of limbic system activation on reproduction and the endocrine milieu.     

穴位埋线治疗更年期综合征及其对性腺激素、β-内啡肽的影响

目的:探索穴位埋线治疗更年期综合征的临床疗效及其机制.方法:将60例患者随机分为埋线组和西药组,每组30例.埋线组选取肾俞、子宫、三阴交进行穴位埋线治疗,西药组每天口服己烯雌酚片,观察比较两组的临床疗效及其对患者血清促卵泡生成激素(FSH)、促黄体生成激素(LH)、雌二醇(E_2)及β-内啡肽的影响.结果:埋线组总有效率为93.3%,西药组总有效率为70.0%,埋线组优于西药组(P<0.05);埋线组β-内啡肽较治疗前明显上升;同时FSH降低,E_2水平升高,与西药组比较差异均有统计学意义(P<0.05,P<0.01).结论:穴位埋线治疗更年期综合征疗效显著,可明显改善患者卵巢功能,对内源性阿片肽类递质具有良性调整作用.     

严重烧伤后下丘脑-垂体-肾上腺皮质轴激素改变的临床观察

目的 动态观察严重烧伤患下丘脑—垂体—肾上腺皮质轴激素水平的变化，为临床治疗和预后提供理论依据。方法 选择50例严重烧伤患，用放射免疫法分别测定其伤后不同时间血浆总皮质醇(GC)、促肾上腺皮质激素(AUH)、醛固酮(ALD0)和尿17—羟皮质类固醇(17—OH)、尿17-酮类固醇(17—KS)的含量，以各项指标的正常值为对照，结合所得数据进行统计学分析。结果 严重烧伤后，患激素水平均显升高，出现休克期和感染期两个高峰；6周后大部分激素水平低于正常值；患死亡前激素水平极低，而创面愈合则逐渐趋于正常。结论 严重烧伤后，下丘脑—垂体—肾上腺皮质轴激素水平呈持续性上升；休克和感染是烧伤后机体应激反应的两个主要因素；如激素含量骤然下降至正常水平以下，表明肾上腺皮质功能已处于衰竭状态，死亡率极高。     

促卵泡生成素、黄体生成素和胰岛素对多囊卵巢病人颗粒细胞甾体激素分泌的影响

目的研究在促卵泡生成素（ＦＳＨ）、促黄体生成素（ＬＨ）和胰岛素（ＩＮＳ）刺激作用下多囊卵巢综合症（ＰＣＯＳ）病人与正常卵巢的颗粒细胞甾体激素产生的异同。方法对１８例月经周期正常妇女卵泡期的３３个卵泡和８例ＰＣＯＳ的１００个卵泡的颗粒细胞行体外培养，利用放射免疫法测定培养液中的甾体激素水平，比较了两组颗粒细胞在ＦＳＨ、ＬＨ和ＩＮＳ刺激作用下雌二醇（Ｅ２）和孕酮（Ｐ）的产生。结果ＰＣＯＳ病人的颗粒细胞在基础状态下，ＦＳＨ和ＩＮＳ刺激作用下Ｅ２产生量明显高于对照组（Ｐ＜００５～００１），在ＦＳＨ、ＬＨ和ＩＮＳ刺激作用下ＰＣＯＳ组产生的Ｐ量明显高于对照组（Ｐ＜００５～００１）；ＩＮＳ能明显的增强ＦＳＨ和ＬＨ对颗粒细胞的刺激作用；外周胰岛素拮抗的ＰＣＯＳ病人的颗粒细胞对ＩＮＳ刺激仍然敏感。结论ＰＣＯＳ病人的颗粒细胞甾体激素合成酶在体内时可能已被活化，ＰＣＯＳ病人的高ＩＮＳ和高ＬＨ血症可能起关键作用     

创伤后早期神经内分泌改变与应激性高血糖

为观察应激时血糖代谢与神经内分泌改变的关系，探讨胰岛素抵抗的机制和意义。对外科大手术后病人30例，于术毕即刻（AS）、脱离呼吸机后（AW）和术日次晨（NW）分别测定外周血糖和胰岛素（INS）、C－肽（GP）、皮质醇（CDRT）、促肾上腺皮质素（ACTH）、生长激素（GH）、胰高糖素（GL）（以上放免法），肾上腺素（E）和去甲肾上腺素（NE）（高效液相色谱法）水平。结果：术后患者的血糖及CORT、ACTH、E和NE均显著升高，分别为2．3g／L，280．7μg／L、47．6ng／L、324．4ng／L和1511．0ng／L，脱机后逐渐下降，至次展显著降低，分别为1．89g／L、134．4μg／L、7．38ng／L、92．6ng／L和9755ng／L。C－P明显升高并和INS一起逐渐递增，在AS和NM分别为3．59μp／Lvs．5．27μg／L和20．8mU／Lvs．32．7mU／L。GH和GL3个时相均在正常范围。结论：外科术后早期存在应激性高血糖和胰岛素抵抗，血糖水平主要受NE调节，24小时后逐渐复常，胰岛素抵抗的原因在于效应细胞的受体下调，是机体应激时重要的自我保护手段。     

男性急性中毒患者血清性激素含量的研究

对３３例男性急性中屠 的血清性激素水平进行了测定。结果显示Ｌ乙醇中毒组血清睾酮（Ｔ）、泌乳素（ＰＲＬ）及黄体生成素（ＬＨ）含量显著高于正常结照组（Ｐ〈０．００１），且Ｔ与中毒时间呈正相关；有机磷农药中毒组和舒乐安定中毒组血清Ｔ、ＰＲＬ、ＬＨ水平亦高于正常对照组（Ｐ〈０．００１），且Ｔ与中毒时间呈负相关 中毒患者血清雌二醇（Ｆ２）值均低于正常对照组（Ｐ〈０．０１或〈０．００１）；Ｔ与ＰＲＬ、ＬＨ及Ｅ