不同能量及营养结构饮食对雌性大鼠性发育的影响

Objective To investigate the effects of diets with different calorie and nutritional values on pubertal onset in female rats. Method Female Wistar rat models receiving calorie-deprived (group R) (Experiment 1) ,fat-rich(group F) ,glucose-rich(group G) and protein-rich(group P) (Experiment 2) test diets were established,and rats receiving diets with normal caloric value were considered as control group (group C). The body weight (BW) ,food-intake and vaginal patency (VP) were observed. The rats were killed at the day of vaginal patency. The BW, uterus weight (UW), uterus index (UI), calorie intake per day (CI), perirenal fat weight (PFW) and perirenal fat index (PFI) were measured. The serum levels of leptin, ghrelin, IGF- Ⅰ were tested by means of ELISA.Results Experiment 1:The VP was retarded in group R compared with group C (P<0. 01). There was a significant difference in BW, UW,UI ,CI,leptin and ghrelin at the VP day between group R and group C (all P<0.01) ,and no significant difference in IGF- Ⅰ levels between these two groups. Experiment 2 :The VP was retarded in group F,group G and group P in comparison with group C (P<0.01). The BW, PFW and PFI in group G and group F were markedly higher than those in group P and group C. The leptin level in group F was the highest, and the lowest in group P. The ghrelin level in group G was the highest,and that in group P was the lowest. However,there were no significant differences in IGF- Ⅰ and UI among these, four groups. Conclusion The normal pubertal onset of female rats requires sufficient caloric stores and balanced nutrient. Diets malnutrition and fat-rich, glucoserich and protein-rich test diets all delay pubertal onset in female rats.     

促性腺激素释放激素类似物治疗特发性中枢性性早熟促身高增长疗效观察

观察促性腺激素释放激素类似物（GnRHa）对改善女性特发性中枢性性早熟（CIPP）和青春发育进展快速型患者促身高增长疗效。结果发现GnRHa能有效改善CIPP终身高，其疗效与治疗前成人期身高的预测、对应骨龄的身高标准差呈正相关。     

不同能量及营养结构饮食对雌性大鼠性发育的影响

Objective To investigate the effects of diets with different calorie and nutritional values on pubertal onset in female rats. Method Female Wistar rat models receiving calorie-deprived (group R) (Experiment 1) ,fat-rich(group F) ,glucose-rich(group G) and protein-rich(group P) (Experiment 2) test diets were established,and rats receiving diets with normal caloric value were considered as control group (group C). The body weight (BW) ,food-intake and vaginal patency (VP) were observed. The rats were killed at the day of vaginal patency. The BW, uterus weight (UW), uterus index (UI), calorie intake per day (CI), perirenal fat weight (PFW) and perirenal fat index (PFI) were measured. The serum levels of leptin, ghrelin, IGF- Ⅰ were tested by means of ELISA.Results Experiment 1:The VP was retarded in group R compared with group C (P<0. 01). There was a significant difference in BW, UW,UI ,CI,leptin and ghrelin at the VP day between group R and group C (all P<0.01) ,and no significant difference in IGF- Ⅰ levels between these two groups. Experiment 2 :The VP was retarded in group F,group G and group P in comparison with group C (P<0.01). The BW, PFW and PFI in group G and group F were markedly higher than those in group P and group C. The leptin level in group F was the highest, and the lowest in group P. The ghrelin level in group G was the highest,and that in group P was the lowest. However,there were no significant differences in IGF- Ⅰ and UI among these, four groups. Conclusion The normal pubertal onset of female rats requires sufficient caloric stores and balanced nutrient. Diets malnutrition and fat-rich, glucoserich and protein-rich test diets all delay pubertal onset in female rats.     

曲普瑞林治疗特发性中枢性性早熟女孩疗效观察

目的　观察促性腺素释放激素类似物 (GnRHa)曲普瑞林 (达菲林 )治疗女孩特发性中枢性性早熟 (ICPP)的作用。方法　在多个中心 (6所医院 )采用曲普瑞林治疗 2 8例ICPP女童 6个月 (4例 )和12个月 (2 4例 ) ,观察乳房及其他第二性征和生长速率变化 ,观察治疗前后B超子宫、卵巢、X线片骨龄(BA)、血清E2 、LHRH激发试验 ,部分病人随访GH激发试验及血清IGF Ⅰ变化。用国际统一标准Greulich Pyle图谱方法评估骨龄 ,Bayley Pinneau方法预测成人终身高。结果　经治疗乳房、子宫、卵巢容积均缩小 ,LHRH激发试验显示LH、FSH峰值显著降低 ,骨龄成熟延缓 ,BA/CA(生活年龄 )比值随疗程而下降。治疗 6个月、12个月按BA的身高标准差分值 (HtSDSBA)从治疗前 -1.46± 0 .16分别增加至 -1.3 0± 0 .15和 -1.0 2± 0 .17(P <0 .0 0 1)。按CA的身高标准差分值 (HtSDSCA)亦随疗程下降 ,治疗前、治疗后6个月、12个月分别为 1.0 5± 0 .2 0、0 .99± 0 .18和 0 .95± 0 .2 0 (P <0 .0 0 1)。预测成人终身高 ,治疗前为(153 .8± 1.1)cm ,治疗后 6个月、12个月各为 (155.0± 1.1)cm和 (157.0± 1.2 )cm。结论　曲普瑞林治疗ICPP可有效抑制性腺轴及性征发育 ,延缓BA成熟和改善预测成人终身高     

生长激素受体基因多态性与特发性矮小遗传易感性的关系

目的探讨人生长激素受体(GHR)基因的单核苷酸多态性(SNP)与中国汉族人群特发性矮小(ISS)遗传易感性的关系。方法采用病例对照法,在199例ISS患儿(ISS组)和469名身高正常成人(对照组)中,对GHR基因16个SNP位点进行基因分型和比较,筛查阳性SNP位点(特异基因型频率差异有统计学意义),分析阳性SNP位点基因型与ISS发病风险及血清胰岛素样生长因子1(IGF-1)等相关临床变量的关系。结果在ISS组和对照组中,发现3个阳性SNP位点rs6182(P=0.027)、rs4410646(P=0.01)和rs10044169(P=0.024)。①rs6182(G/T):在T显性模式下,TT和GT基因型的ISS发病风险降低(OR=0.624,95%CI:0.402~0.969,P=0.021)。②rs4410646(A/C):在C显性模式下AA基因型的ISS发病风险降低(OR=0.674,95%CI:0.475~0.958,P=0.016);该位点的多因素Logistics回归分析显示,以CC基因型为参照,血清IGF-1与基因型AA(OR=1.011,95%CI:1.002~1.020,P=0.018...     

单纯促性腺激素释放激素类似物或联合重组人生长激素治疗青春期矮小患儿的疗效分析

目的 比较分析单纯促性腺激素释放激素类似物(GnRHa)或联合重组人生长激素(rhGH)治疗青春期非生长激素缺乏矮小(NGHDSS)患儿的助长疗效,探讨科学有效的青春期助长治疗方案.方法 42例青春期NGHDSS患儿(男性14,女性28),采用GnRHa联合rhGH治疗者(联合组)30例,单独GnRHa 治疗者(单治组)12例.GnRHa初始剂量100ug·kg-1·d-1(28 d),维持剂量60-80μg·kg-1·d-1(28d);rhGH初始剂量0.15 IU·ks-1·d-1(28 d),维持剂量0.10～0.15 IU·ks-1·d-1(28 d),疗程均为1-2年.主要观察各组年生长速率(GV)、对年龄的身高标准差分值(HtSDSCA)、对骨龄的身高标准差分值(HtSDSBA)、预测身高标准差分值(PAHSDS)的动态变化.结果 (1)1年疗效:联合组治疗前后比较,GV、HtSDSCA、HtSDSBA、PAHSDS变化均有统计学意义(均P<0.05).单治组患儿治疗前后比较,GV、HtSDSCA、HtSDSBA、PAHSDS变化均无统计学意义(均P>0.05).2组间比较,GV、HtSDSBA、PAHSDS均有显著性差异(均P<0.05).(2)2年疗效:联合组治疗前后比较,GV、HtSDSCA、HtSDSBA、PAHSDS变化均有统计学意义(均P<0.05).单治组治疗前后比较,GV、HtSDSCA、HtSDSBA、PAHSDS变化均无统计学意义(均P>0.05).2组间比较,GV、HtSDSBA、HtSDSCA、PAHSDS均有显著性差异(均P<0.05).结论 采用GnRHa联合rhGH治疗青春发育初期的NGHDSS患儿能有效促进近期生长速率,其疗效明显优于单独GnRHa治疗,但对成年终身的贡献尚待研究.

Abstract：

Objective To assess the efficacy of gonadotropin-releasing hormone analogue(GnRHa)with or without recombinant human growth hormone(rhGH)treatment in Chinese short pubertal children with non-growth hormone deficiency.Methods Of 42 short pubertal children(14 males,28 females)without growth hormone deftcieney,the average age was(11.6±0.8)year.30 children were treated with slow release GnRHa with initial dose (100μg·kg-1·d-1,28d)and maintenance dose(60-80μg·kg-1·d-1,28d)labd rgGH with initial dose(0.15IU·kg-1·d-1)and maintenance dose(0.10-0.15IU·kg-1·d-1)for at least 1year.16 of them were still ongoing till the end of the second year.12 children were treated with GnRHa alone by initial dose(100μg·kg-1·d-1,28d)and maintenance dose (60-80μg·kg-1·d-1,28d),and 7 of them remained on it for 2 years.Dynamic changes including annual growth velocity(GV),bone age(BA)/chronologic age(CA)ratio,Tanner stage,height SDS for CA (HtSDSCA),height SDS for BA(HtSDSBA),and predicted adult height (PAHSDS)were observed.Results By the end of the first year tretment with combination therapy,the following parameters:GV,HtSDSCA,HtSDSBA,and PAHSDS all increased significantly(all P<0.05).Treatment with GnRHa alone did not yield significant changes in GV,HtSDSCA,HtSDSBA,and PAHSDS(all P>0.05).Changes in GV,HtSDSBA,and PAHSDS between these two groups were statistically significant(all P<0.05).By the end of the second year treatment,in the combination group,GV slowed from 6.7 to 5.5 cm/year(P<0.05).HtSDSCA,HtSDSBA,PAHSDS increased(all P<0.05).In the group with GnRHa treatment alone,GV slowed from 4.0 to 3.6 cm/year(P>0.05).HtSDSCA,HtSDSBA,PAHSDS increased(all P>0.05).Changes in GV,HtSDSCA,HtSDSBA,and PAHSDS between these 2 groups were statistically significant respectively(all P<0.05).Conclusion This combined treatment regimen significantly impreved the growth by increasing growth rate and delaying bone matumtion in pubertal chidren without growth hormone deficiency.Further study is needed to verify beneficial effects on the final height gain.     

生长激素缺乏症生化检测综合分析

目的以临床诊断作为矮小症患儿(可疑GHD)诊断标准,评估生长激素激发试验、胰岛素样生长因子Ⅰ(IGFⅠ)及IGF结合蛋白3(IGFBP3)对GHD的诊断价值。方法放免方法检测84例可疑GHD患者及63例非GHD患者GH峰值、IGFⅠ及IGFBP3,运用ROC曲线方法选定各生化检测的最佳截定值,并计算各最佳截定值的敏感性(sensitivity,S)、特异性(specificity,Sp)及诊断有效率(diagnosticefficiency,DEf)。结果ROC曲线显示GH激发试验GH峰值7.65μg/L为最佳截定值,DEf达84.4%,S为75.9%,Sp达94.9%;IGFⅠSDS最佳截定值为-1.85,S为70.2%、Sp为83.1%、DEf为70.2%;IGFBP3SDS最佳截定值为-1.55,比传统-2SD高,DEf为64.3%,Sp较高(89.8%),但S仅为45.8%。联合使用上述3种测定有较佳的DEf(91.2%),S(89.3%)和Sp(93.7%)。结论GH激发试验如选取一个好的截定值(本研究为GH峰值7.65μg/L),则该试验对GHD具有较高诊断价值;单个IGFⅠ检测则逊于GH激发试验;IGFBP3单独诊断GHD价值不大。三者联合使用诊断率及准确率皆很高,最具诊断价值。     

女孩特发性性早熟血清瘦素测定及意义

目的 观察瘦素在女孩性发育过程中的变化及临床意义。方法 利用放射免疫分析法（RIA）测定20例特发性性早熟（ICPP）女孩（其中A1组10例为6－7^11/12岁，A2组10例为8－9^11/12岁）血清瘦素水平，并与正常同年龄对照组女孩比较。结果 （1）ICPP（A1、A2）组女孩血清瘦素水平较正常同年龄对照组女孩明显升高，且差异有显著性；（2）A1、A2二组之间瘦素水平则差异无显著性；（3）血清瘦素水平与其体重呈正相关。结论 性发育启动需要一定的体重及瘦素水平，瘦素很可能是性发育启动的一个允许因子，对性发育过程起了促进作用。     

门诊注射室护士发生针刺伤的相关因素分析与防护对策

目的:了解门诊注射室护士针刺伤发生的相关因素,探讨有效的防护措施。方法:采用回顾性调查问卷,对曾在或正在注射室工作的16名护理人员进行调查。结果:护士在护理操作中无一例外均被针刺伤;工作忙碌时,拔针时最易发生针刺伤;精神紧张、精力不集中也是导致针刺伤不可忽视的重要因素;在注射后处置针头,整理、收集污物时常常发生针刺伤。结论:门诊注射室护士工作在第一线,常在患者未明确诊断前即已投入对患者的处置与治疗,护士常被暴露于潜伏期或诊断前的血液传播疾病的危险中。因此,增强针刺伤的自我防护意识,及时采取应对措施,对减少职业伤害具有极其重要的作用。     

产科监测尿中白蛋白的意义

196 3年Ｋｅｅｎ等人最先应用放射免疫法测定尿中白蛋白 ,随着研究的日趋深入 ,1982年Ｖｉｂｅｒｔｉ等人进一步提出微量白蛋白尿 (ｍｉｃｒｏａｌｂｕｍｉｎｕｒｉａ ,ＭＡ)的概念 ,用于界定尿中白蛋白已呈亚临床升高 ,但尿常规检测尿蛋白阴性的一种病理现象。ＭＡ已成为早期诊断糖尿病肾病、高血压肾病及其它原因引起的肾小球损伤的敏感指标[1] 。在产科领域探索了正常妊娠及妊娠合并糖尿病、妊娠高血压综合征(ｐｒｅｇｎａｎｃｙ -ｉｎｄｕｃｅｄｈｙｐｅｒｔｅｎｓｉｏｎ ,ＰＩＨ)等高危妊娠时尿中白蛋白的变化。ＭＡ还尝试用于早期预测…