黄体酮胶丸用于早期先兆流产保胎治疗效果观察

目的：探讨黄体酮胶丸用于早期先兆流产保胎治疗的效果。方法：采用口服黄体酮胶丸（口服组）和肌内注射黄体酮（肌注组）治疗先兆流产患者30例,对比观察其临床症状、体征及血清孕酮（P）水平。结果：两组间临床症状、体征及P水平差异均无显著性。结论：口服黄体酮胶丸与肌内注射黄体酮治疗先兆流产均有良好疗效,但口服治疗较方便可行,而且患者能得到较好的休息,避免肌内注射引起的疼痛。所以黄体酮胶丸用于治疗黄体功能不全所致的先兆流产效果安全、可靠,具有可行性。     

血清孕酮检测在异位妊娠早期诊断中的价值

目的探讨血清孕酮检测在异位妊娠早期诊断中的价值。方法选择确诊的异位妊娠患者36例及正常宫内妊娠者30例,检测并比较两者血清孕酮值。结果（1）异位妊娠患者血清孕酮（5．12±3．98）μg/L明显低于正常宫内妊娠者血清孕酮（25．23±6．81）μg/L,两者比较差异有统计学意义（P〈0．01）。（2）以血清孕酮11μg/L作为诊断异位妊娠的临界值,诊断异位妊娠的灵敏度为91．7％（33／36）,特异度为93．3％（28／30）,漏诊率为8．3％（3／36）。结论血清孕酮检测方法简便、快捷,可作为一种早期诊断异位妊娠的手段。     

孕酮对吗啡位置偏爱大鼠相关脑区中亮氨酸脑啡肽水平的影响

目的:观察孕酮对于吗啡所致奖赏效应及相关脑区中亮氨酸脑啡肽水平的影响。方法:将40只SD大鼠随机均分为对照组(环糊精)、吗啡组、孕酮组和孕酮+吗啡组,建立吗啡条件性位置偏爱(CPP)模型,上午各组皮下给予相应药物后放入白室训练45min;下午各组均皮下和腹腔给予等量的环糊精和生理盐水后放入黑室训练。连续训练10d后进行CPP测试并处死大鼠取脑组织采用放射免疫法测定大鼠不同脑区中亮氨酸脑啡肽(L-EK)的含量。结果:与对照组比较,吗啡组发生CPP效应,下丘脑、伏隔核和额叶皮质中的L-EK水平显著降低(P<0.05或P<0.01);与吗啡组比较,孕酮+吗啡组CPP效应受到抑制,上述位置中L-EK水平显著升高(P<0.05或P<0.01),而海马和中脑内L-EK水平未见显著性变化。结论:孕酮可以有效抑制吗啡CPP效应,其机制可能与其逆转吗啡诱导的相关脑区中的L-EK水平的变化有关。     

肌肉注射黄体酮致局部不良反应相关因素分析

目的：分析肌肉注射黄体酮所致局部不良反应的相关因素,明确不良反应的发生原因。方法：回顾性分析2007年5月-2008年7月在我院行IVF-ET术后肌肉注射黄体酮的152例患者的临床资料,对所得数据采用SPSS13．0统计软件包进行统计学分析。结果：将152例患者分为两组,A组78例应用黄体酮每次6支（10mg·mL^-1）,出现注射反应19例。人工性脂膜炎9例;而B组74例应用黄体酮每次3支（20mg·mL^-1）,仅1例出现注射反应,无人工性脂膜炎。结论：肌肉注射黄体酮发生不良反应可能与黄体酮溶媒量或溶媒质量相关。可采用局部治疗。     

超排卵对小鼠着床期雌、孕激素及其受体的影响及中药调节

目的:观察补肾安胎方对超排卵小鼠阴栓阳性率、妊娠率、着床位点数和雌、孕激素及其受体水平的影响。方法:将180只小鼠随机分为正常组、模型组和中药组。模型组和中药组注射孕马血清促性腺激素(PMSG)和HCG建立小鼠超排模型后合笼,正常组注射等体积生理盐水后合笼,妊娠第1、2、5、8天留取血清或子宫及卵巢。观察每组小鼠的阴栓阳性率、妊娠第8天妊娠率和着床位点数;采用放免法检测各组小鼠雌、孕激素含量;采用免疫组化技术检测小鼠子宫雌、孕激素受体表达水平。结果:①模型组阴栓阳性率、妊娠率显著低于正常组(P<0.05),胚泡着床位点数显著高于正常组(P<0.05);中药治疗后阴栓阳性率、妊娠率显著高于模型组(P<0.05),胚泡着床位点数较模型组降低(P<0.05)。②妊娠第1、2天各组小鼠卵巢重量比较:模型组和中药组显著高于正常组(P<0.05),妊娠第1天中药组和模型组比较差异无统计学意义,妊娠第2天中药组显著低于模型组(P<0.05)。③血清雌、孕激素水平:妊娠第1、5、8天同时期3组血清雌激素水平比较差异无统计学意义,模型组孕激素水平显著高于正常组(P<0.05),中药治疗后孕激素水平降低,与正常组比较差异无统计学意义。④子宫内膜雌、孕激素受体表达:模型组雌、孕激素受体水平较正常组降低,中药治疗后较模型组升高。结论:补肾安胎方能提高超排卵小鼠阴栓率和妊娠率,调节超排卵小鼠的着床位点数,其机制可能与该方能改善甾体激素水平,调节子宫内膜雌、孕激素受体表达有关。     

Breast cancer,stem cells and sex hormones: Part 1. The impact of fetal life and infancy

Like other organs, the breast contains rare somatic stem cells (SCs) that are long-lived and slowly dividing. In the adult breast, they are closely regulated in areas located along the breast ducts called SC niches. Breast SCs can produce offspring that become ductal, alveoli or myoepithelial cells. In fetal life, SCs form the primitive breast ducts and up to 30 weeks of gestational age, this process appears to be largely independent of estrogen. Early life risk factors for breast cancer include birth weight, rapid growth during infancy and diet. The impact of these risk factors may be mediated through SC number. These somatic breast SCs persist into adult life and so they are exposed to oncogenic influences for much longer than the short-lived differentiated breast ductal and alveolar cells. As such, it is likely that the breast SC is a prominent target for carcinogenesis and so SC number may be an important determinant of breast cancer risk later in life.     

Progestogen deficiency and endometrial cancer risk

There is a close relationship between the amount of estogen and progesterone secreted by the ovary from puberty to menopause and the development of hyperplastic endometrium of all types and finally endometrial cancer. The endogenous endocrine pattern reflects progesterone deficiency (corpus luteum deficiency). Such deficiency can also develop when treatment with exogenous estrogen and progestogen is done and a deficiency of the progestogen in comparison to the used estrogen is induced in pre- and postmenopausal women. This risk is particular accentuated in the climacteric female when the endocrine milieu was unfavorable in the years before (menstrual cycle disorders, PCOS, obesity, no full-term pregnancy, no breast feeding, etc.).However, there are the additional factors, which modify the biological end result: “Progestogen deficiency”. One main factor is the level of SHBG determined by the amount of free, biologically active estradiol. A low level of SHBG is for instance induced by high body weight. Therefore, the amount of overweight correlates with increased risk of endometrial hyperplasia and finally endometrial cancer. In addition, increasing body weight negatively affects proper ovarian function leading to corpus luteum deficiency and this in addition increases the risk of endometrial cancer. The classical risk increase for endometrial cancer is associated with oligomenorrhea or polymenorrhea combined with corpus luteum deficiency or anovulation. Therefore, women with PCOS are at increased risk for endometrial cancer in the pre- and postmenopausal years. Examples from the therapeutic point of view have been the risk increase found with biphasic estrogen high-dosed oral contraceptives with a long estrogen phase and a short progestogen phase. In climacteric females estrogen-only treatment results in a predictable increase in endometrial cancer risk. Therefore, it is mandatory to use estrogen/progestogen combinations. The lowest risk is achieved when a continuous estrogen/progestogen regimen is used. In addition, the lowest dose of estrogens for the individual woman should be chosen.     

雌激素孕激素及妈富隆三种方法治疗青春期功血180例临床分析

目的:观察三种不同方法治疗青春期功血的临床疗效.方法:随机将诊断青春期功血的180例患者分为雌激素组、孕激素组和妈富隆组.结果:妈富隆组的完全止血时间较雌激素、孕激素组明显缩短(P＜0.05),不良反应明显减少(P＜0.05).结论:妈富隆用于治疗青春期功血治疗效果肯定,不良反应少,患者依从性好,值得临床推广.