EMs患者长效GnRHa降调节后人工周期行FET的临床结局

目的:探讨长效促性腺激素释放激素激动剂(GnRHa)降调节对行冻融胚胎移植(FET)的子宫内膜异位症(EMs)患者临床结局的影响。方法:选择2016年1月—2018年1月于山东中医药大学第二附属医院生殖医学科行FET的EMs患者共计320例,随机分为长效GnRHa降调节后人工周期组(A组,160例)和单纯人工周期组(B组,160例),观察2组患者一般资料、临床指标和妊娠结局。结果:2组患者的一般资料、黄体酮转化日CA125水平、孕酮(P)水平、移植胚胎数、早期流产率比较差异均无统计学意义(P0.05);A组黄体酮转化日雌二醇(E2)水平显著低于B组(P0.05),A组黄体酮转化日子宫内膜厚度、黄体酮转化日A型子宫内膜比例、临床妊娠率、胚胎着床率和活产率均高于B组(P0.05)。结论:长效GnRHa降调节后人工周期准备内膜可以改善行FET的EMs患者的临床结局。     

EMs患者长效GnRHa降调节后人工周期行FET的临床结局

目的：探讨长效促性腺激素释放激素激动剂（GnRHa）降调节对行冻融胚胎移植（FET）的子宫内膜异位症（EMs）患者临床结局的影响。方法：选择2016年1月—2018年1月于山东中医药大学第二附属医院生殖医学科行FET的EMs患者共计320例，随机分为长效GnRHa降调节后人工周期组（A组，160例）和单纯人工周期组（B组，160例），观察2组患者一般资料、临床指标和妊娠结局。结果：2组患者的一般资料、黄体酮转化日CA125水平、孕酮（P）水平、移植胚胎数、早期流产率比较差异均无统计学意义（P＞0.05）；A组黄体酮转化日雌二醇（E2）水平显著低于B组（P＜0.05)，A组黄体酮转化日子宫内膜厚度、黄体酮转化日A型子宫内膜比例、临床妊娠率、胚胎着床率和活产率均高于B组（P＜0.05）。结论：长效GnRHa降调节后人工周期准备内膜可以改善行FET的EMs患者的临床结局。     

Association between Cardiac Changes and Stress,and the Effect of Peroxisome Proliferator-activated Receptor-γ on Stress-induced Myocardial Injury in Mice

This study was aimed to investigate the effect of stress induced by high-intensity exercises on the cardiovascular system. In the epidemiological investigation, 200 subjects(test group) engaged in special high-intensity exercises, and 97 who lived and worked in the same environment and conditions as those in the test group, but did not participate in the exercises served as controls. In the second part of the study, 50 mice were randomly divided into control group, exhaustive swimming group, white noise group, exhaustive swimming plus white noise group, and pioglitazone intervention group. The results showed that the plasma concentrations of the myocardial injury markers heart fatty acid-binding protein(H-FABP), C-reactive protein(CRP), β-endorphin(β-EP) and levels of psychological stress were significantly increased in test group as compared with control group; special high-intensity exercises resulted in a significant elevation of the incidence of cardiac arrhythmias. Animal experiments showed that the plasma levels of corticosterone(CORT) and troponin I(Tn I) were raised while the level of SOD was reduced in exhaustive swimming group, white noise group, and exhaustive swimming plus white noise group. The expression levels of PPARγ m RNA and protein were decreased in myocardial tissues in these groups as well. HE staining showed no remarkable change in myocardial tissues in all the groups. Treatment with pioglitazone significantly decreased the plasma levels of Tn I and CORT, while increased the level of SOD and the expression levels of PPARγ m RNA and protein. It was concluded that the high-intensity exercises may induce a heavy physical and psychological stress and predispose the subjects to accumulated fatigue and sleep deprivation; high-intensity exercises also increases the incidence of arrhythmias and myocardial injury. PPARγ may be involved in the physical and psychological changes induced by high-intensity exercises.     

中医斜扳疗法治疗腰椎间盘突出的生物力学研究

目的对椎间盘突出等腰椎病中医推拿斜扳疗法进行生物力学建模分析研究,比对脉冲激励的传统斜扳法和简谐激励的改良斜扳法两种不同手法的力学特性。方法假设椎骨为刚体,椎间盘及周围韧带等软组织为黏弹性体,建立模拟L1～5的5自由度振动系统,对基本方程进行解析求解。结果简谐激励改良斜扳法的疗效与频率有关。在频率≤1的简谐激励改良斜扳法作用下,病变节段最大位移都大于脉冲激励传统斜扳法下的最大位移。随着病变位置下移,简谐激励改良斜扳法的损伤比相比脉冲激励传统斜扳法逐渐下降,安全性增高。结论使用频率≤1的简谐激励改良斜扳法,治疗效果优于脉冲激励传统斜扳法,且可控制损伤。     

BDNF基因的Val66Met多态性与子宫内膜异位症性不孕的相关性及对IVF-ET助孕结局的影响

目的:观察脑源性神经营养因子(BDNF)基因的Val66Met多态性与子宫内膜异位症(EMs)性不孕的相关性,探讨BDNF基因变异对体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法:收集2015年9月—2016年9月于山东中医药大学第二附属医院生殖医学科就诊,且因Ⅲ~Ⅳ期EMs行IVF-ET的患者112例为观察组,并选取同期因单纯输卵管因素行IVF-ET患者109例为对照组,探讨2组间BDNF基因的Val66Met多态性分型比例,进一步分析2组中不同基因型患者的IVF-ET妊娠结局。结果:(1)2组患者的年龄、不孕年限、体质量指数(BMI)、基础卵泡刺激素(FSH)和基础雌二醇(E_2)水平比较,差异无统计学意义(均P0.05)。(2)观察组Met/Met基因型所占比例和Met等位基因频率较对照组显著增高(33.0%vs.23.9%,P=0.043;58.9%vs.47.7%,P=0.018);2组中携带Met/Met基因型的患者较携带其他2种基因型患者使用的Gn剂量更高(P0.05),但成熟卵数(4.5±3.2 vs.5.2±2.3)、受精率(59.0%vs.67.0%)却更低(均P0.05)。(3)2组患者中Met/Met基因型者相比于另外2种基因型者卵泡液中的BDNF蛋白水平明显下降(P0.05),但月经期和人绒毛膜促性腺激素(h CG)日血浆中BDNF含量差异无统计学意义(P0.05)。结论:BDNF基因Val66Met多态性与EMs性不孕的发生密切相关,且可能导致患者对IVF-ET治疗的反应性降低。     

儿童抗菌药物106例药品不良反应报告分析

目的：了解我院儿童使用抗菌药物所致药品不良反应（ADR）发生的特点及规律。方法：对我院2012年1～12月收集的儿童使用抗菌药物所致106例ADR报告,分别从年龄、性别,使用抗菌药物种类、原患疾病的种类、ADR类型及临床表现等方面进行统计、分析。结果：所致ADR的抗菌药物共4类13种,ADR的发生率：头孢菌素类为59．43％;青霉素类为29．75％;其他类为9．43％;大环内酯类为1．89％。ADR的临床表现以皮疹、荨麻疹为主。结论：医院应重视儿童的ADR监测,注意儿童用药个体化,保障儿童健康成长。     

话说卵磷脂

近来有许多病人来咨询卵磷脂的功用、如何服用等等问题,由鉴于此,笔者对卵磷脂的保健功用等问题浅析如下。卵磷脂,又名软磷脂,是1844年法国人Gohley从蛋黄中发现的,英文名为Lecithin。卵磷脂被誉为与蛋白质、维生素并列的"第三营养素"。