多囊卵巢综合征患者检测抗苗勒氏管激素的应用价值

目的探究多囊卵巢综合征(PCOS)患者检测抗苗勒氏管激素(AMH)的应用价值。方法选取2019年3月-2019年9月该院生殖中心收治的203例PCOS患者作为观察组,再选取同期该院妇科收治的196例卵巢功能正常者作为对照组。检测两组研究对象的性激素[卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH)、孕酮(P)、催乳素(PRL)、睾酮(T)]水平、AMH水平、月经周期,不同年龄阶段AMH水平;分析AMH水平与性激素水平之间的相关性。结果观察组AMH水平及月经周期明显多于对照组,差异有统计学意义(P0.05);不同年龄阶段AMH水平比较,随着年龄增加,体内AMH水平逐渐下降,差异有统计学意义(P0.05);两组研究对象催乳素(PRL)水平比较,差异无统计学意义(P0.05);观察组FSH水平明显低于对照组,观察组E_2、LH、P、T水平明显高于对照组,差异有统计学意义(P0.05); AMH与FSH和LH呈负相关(P0.05),AMH与P、E2呈正相关(P0.05); AMH对PCOS有一定的诊断价值,当AMH=7.55 ng/ml时,其诊断PCOS的最高灵敏度为85.40%,最高特异度为92.10%。结论 AMH能够准确反映出PCOS患者症状的严重程度,是评估女性生殖功能的重要参考指标,同时结合性激素检测能够准确评估女性的卵巢储备功能,值得临床进一步推广及使用。     

AFC AMH BMP-15 bE_2与bFSH在年轻不孕症女性卵巢低反应与妊娠结局预测中的价值

目的探讨窦卵泡数(AFC)、抗苗勒氏管激素(AMH)、骨形态发生蛋白-15 (BMP-15)、基础雌二醇(bE2)与基础卵泡刺激素(bFSH)在年轻不孕症女性患者卵巢低反应与妊娠结局预测中的价值,为临床诊治提供参考依据。方法选取2015年1月-2017年3月间宁夏泾源县妇幼保健院收治的100例30岁以下行体外受精(IVF)或卵泡浆内单精子注射(ICSI)助孕治疗患者作为研究对象,检测患者体内AFC、AMH、BMP-15、bE_2与bFSH水平,绘制ROC曲线分析各指标的预测卵巢低反应与妊娠结局的价值。结果卵巢反应性低患者体内AFC、AMH、BMP-15水平显著低于卵巢反应正常组,bE_2及bFSH水平显著高于卵巢反应正常组,差异有统计学意义(均P0.05);未妊娠患者体内AFC、AMH、BMP-15水平显著低于正常妊娠组,bE_2及bFSH水平显著高于正常妊娠组,差异有统计学意义(均P0.05);预测卵巢反应性低发生时,采用平行联合预测的特异度显著高于各指标单独应用(P0.05),系列联合诊断灵敏度显著高于各指标单独应用(P0.05),且平行联合和系列联合预测的ROC曲线下面积显著高于各指标单独应用(P0.05);预测临床妊娠结局时,采用平行联合预测的特异度显著高于各指标单独应用(P0.05),系列联合诊断灵敏度显著高于各指标单独应用(P0.05),且平行联合和系列联合预测的ROC曲线下面积显著高于各指标单独应用(P0.05)。结论在对年轻不孕症女性卵巢低反应与妊娠结局进行预测时,可通过联合AFC、AMH、BMP-15、bE_2与bFSH多指标,可有效提高诊断灵敏度及特异度,改善诊断效能。     

基础FSH对预测年轻不孕患者促排卵中卵巢反应性的价值

目的:探讨基础卵泡刺激素值(bFSH)预测FSH正常的年轻不孕患者促排卵周期中卵巢反应性的价值。方法:回顾性分析2009年1～12月因男方因素或原因不明的年轻不孕症患者76例,且bFSH正常(≤8.5 mIU/ml),均采用重组人促卵泡激素针(r-FSH)促排卵治疗,共76个周期,分析bFSH与年龄、基础黄体生成素、雌二醇、促排卵用药的时间、用药总量以及卵泡个数、最大卵泡数,内膜厚度及妊娠结局之间的相关性。结果:bFSH与卵泡个数呈负相关(P<0.01),与内膜厚度呈正相关(P<0.05);促排卵治疗后14例临床妊娠,临床妊娠率为18.4%(14/76),妊娠组和非妊娠组bFSH值分别为(7.31±1.29)mIU/ml vs(6.98±0.51)mIU/ml,结果达统计学意义(P<0.01)。结论:较低的bFSH水平患者在年轻不孕症患者促排卵中能获得较多的卵泡数和较高的临床妊娠率,bFSH水平可能是预测bFSH正常且年轻的不孕患者卵巢反应性的一项较好指标。     

基础FSH/LH比值评估年轻女性卵巢功能的价值

目的探讨年轻女性基础卵泡刺激素(bFSH)与黄体生成素(bLH)比值在评估卵巢储备功能和预测IVF助孕结局中的作用。方法回顾性分析在该中心采用短效长方案、年龄小于40岁及FSH<10mIU/ml的733例IVF助孕患者,根据基础FSH/LH比值分为4组:组1:FSH/LH≥3;组2:20.05)。结论FSH/LH比值是评估年轻女性卵巢储备功能的良好指标,可用于预测患者对IVF超排的反应,指导临床用药。     

多囊卵巢综合征患者血清抗米勒管激素和窦卵泡计数水平与卵巢储备功能下降的相关性

目的 探究多囊卵巢综合征(PCOS)患者血清抗米勒管激素(AMH)和窦卵泡计数(AFC)水平及其与卵巢储备功能下降(DOR)发生风险的相关性。方法 选择2021年8月至2022年8月于四川绵阳四○四医院就诊的173例PCOS患者,根据血清卵泡刺激素(FSH)或雌二醇(E₂)水平,将PCOS患者分为DOR组(45例)和非DOR组(128例),比较两组患者的一般资料及生化指标、AMH和AFC水平及卵巢储备功能相关指标。采用Pearson检验分析PCOS合并DOR患者中AMH、AFC与卵巢储备功能指标的相关性,构建PCOS患者发生DOR的列线图预测模型,并评估其预测效能及准确度和有效性。结果 DOR组患者的AMH、AFC水平明显低于非DOR组,年龄、黄体生成素(LH)、FSH、FSH/LH、E₂、睾酮(T)明显高于非DOR组(t=7.417、10.598、2.681、24.222、7.801、11.334和156.602,P<0.05),AMH、AFC分别与FSH、LH、FSH/LH、T呈显著负相关,与E₂呈显著正相关(...     

抗缪勒氏管激素在诊断多囊卵巢综合征中的临床价值

目的探讨抗缪勒氏管激素(anti-Mullerianhormone,AMH)在诊断多囊卵巢综合征(polysystic ovary syndrome,PCOS)中的临床价值。方法检测90例PCOS患者及80例年龄匹配的健康对照者血清AMH、卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)、血清脱氢表雄酮(DHEAS)、性激素结合球蛋白(SHBG)、空腹血糖、空腹胰岛素水平,及比较PCOS患者与健康对照者的AMH水平差异;以及50例高T值组PCOS患者(T值≥100 ng/dl)和40例正常T值组PCOS患者(T值100 ng/dl)上述指标的差异和相关性。结果 PCOS患者AMH水平与对照组比较,差异有统计学意义(P0.05);高T值组与正常T值组PCOS患者AMH、LH、LH/FSH、DHEAS水平差异有统计学意义(P0.05),而年龄、SHBG、葡萄糖、胰岛素水平比较,差异无统计学意义(P0.05),且高T值组PCOS患者AMH、LH、LH/FSH、DHEAS水平均高于正常T值组。总PCOS组患者AMH水平与LH水平呈正相关(P0.05)。正常T值组患者AMH水平与LH呈正相关(P0.05)。结论 PCOS患者血清AMH水平明显增高,对诊断PCOS患者有重要的临床价值。     

多囊卵巢综合征患者脂联素及脂联素受体表达的对照研究

目的:探讨不同表现型多囊卵巢综合征(PCOS)患者血清和卵泡液中脂联素水平及黄素化颗粒细胞脂联素、脂联素受体mRNA表达的差异,及其对卵子成熟和IVF结局的影响。方法:随机选择行体外受精-胚胎移植(IVF-ET)的71例患者并分4组,第1组为肥胖PCOS组(BMI>24kg/m2)14例,第2组为正常体重PCOS组(BMI≤24kg/m2)22例,第3组为肥胖非PCOS组(BMI>24kg/m2)17例,第4组为正常体重非PCOS组(BMI≤24kg/m2)18例。采用酶联免疫吸附法(ELISA)测定采卵日血清和卵泡液中脂联素蛋白表达水平,逆转录聚合酶链反应(RT-PCR)半定量测定卵巢黄素化颗粒细胞脂联素、脂联素受体mRNA的表达水平。结果:两组PCOS患者血清与卵泡液中脂联素及颗粒细胞脂联素受体水平与相应对照组无差异;肥胖患者(PCOS或非PCOS)中血清脂联素与颗粒细胞脂联素受体的表达低于正常体重者(P<0.05);4组卵泡液脂联素含量明显低于血清含量(P<0.05)且两者显著相关(r=0.38,P<0.01);颗粒细胞内无脂联素mRNA的表达;PCOS患者血清脂联素与BMI负相关(r=-0.394,P<0.05),与注射HCG日>14mm卵泡数正相关(r=0.381,P<0.05);妊娠患者血清脂联素水平明显高于未妊娠者(P<0.05)。结论:人卵巢黄素化颗粒细胞有脂联素受体mRNA的表达,但不表达脂联素mRNA;脂联素及其受体表达与肥胖密切相关,与PCOS无明显相关性;采卵日血清中高水平脂联素可预示良好的IVF结局。     

40岁以上多囊卵巢综合征与非多囊卵巢综合征患者的内分泌特征分析

目的分析40岁以上多囊卵巢综合征(PCOS)与非多囊卵巢综合征患者的内分泌特征。方法选取2016年1月-2018年12月在长春市妇产医院生殖医学中心接受IVF-ET助孕的40岁以上PCOS患者(PCOS组) 49例和非PCOS患者(非PCOS组) 107例为研究对象,收集记录两组患者的年龄、不孕年限、体质量、BMI,检测血清卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)、雌二醇(E2)、抗苗勒管激素(AMH)水平,监测基础窦卵泡数(b AFC)。比较两组内分泌特征。结果两组患者BMI和不孕年限比较,差异有统计学意义(P0. 05)。两组患者b AFC、FSH、LH、LH/FSH、T、AMH水平比较,差异有统计学意义(P0. 05);两组患者泌乳素(PRL)、E2水平比较,差异无统计学意义(P0. 05)。结论 40岁以上高龄PCOS与非PCOS患者的不孕年限、BMI和内分泌特征不同。     

多囊卵巢综合征与相关微小RNA的研究进展

微小RNA(mi RNAs)是一组小分子非编码RNA,在转录后水平调控基因的表达。mi RNAs水平与糖尿病、胰岛素抵抗相关;多囊卵巢综合征(PCOS)患者外周血以及卵泡液中存在某些mi RNAs,提示mi RNAs可能作为PCOS相关的潜在生物标志物。研究发现,PCOS肥胖患者血清mi R-21、mi R-27b、mi R-103和mi R-155这4种mi RNAs的表达明显增加;而mi R-222、mi R-146a和mi R-30c这3种mi RNAs具有作为PCOS的血清生物标志物的某种可能性。卵泡液表达丰富的成熟mi RNAs,PCOS患者卵泡液中mi R-132和mi R-320表达显著低水平;mi R-224、mi R-376a和mi R-143这3种mi RNAs也可能作为PCOS病理生理机制研究的靶标。由于PCOS的异质性,不同研究得到的mi RNAs表达谱也不完全相同,所以对与PCOS相关的mi RNAs尚需进一步研究。     

高原地区多囊卵巢综合征患者抗苗勒氏管激素与临床检测指标的相关性分析

目的探究高原地区多囊卵巢综合征(PCOS)患者抗苗勒氏管激素(AMH)与临床检测指标的相关性。方法选取2016年2月-2017年2月青海红十字医院妇科诊治的PCOS患者100例,根据身体质量指数(BMI)水平分为肥胖组(BMI≥25 kg/m2)和非肥胖组(BMI25 kg/m2)各50例,另取同期参加体检的育龄期健康女性50例为对照组。检测所有研究对象血清AMH、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、睾酮、空腹血糖(FBG)和空腹胰岛素(FINS)水平,并计算稳态模型胰岛素抵抗指数(HOMA-IR),比较3组上述指标并行Pearson相关性分析。设计调查表,通过多因素Logistic回归分析探究PCOS患者AMH的影响因素。结果肥胖组和非肥胖组患者AMH、LH、睾酮、FINS和HOMA-IR水平均高于对照组,差异均有统计学意义(P0.05)。肥胖组LH低于非肥胖组,FINS和HOMA-IR高于非肥胖组,差异均有统计学意义(P0.05);两组AMH水平差异无统计学意义(P0.05)。肥胖组AMH与睾酮、FBG、FINS和HOMA-IR呈正相关,与E2和FSH呈负相关(P0.05);非肥胖组AMH与LH和睾酮呈正相关(P0.05);两组AMH与BMI均无相关性(P0.05)。经多因素Logistic回归分析,睾酮含量高、LH含量高、糖耐量异常、胰岛素抵抗的PCOS患者AMH水平较高。结论高原地区PCOS患者的血清AMH有所增加,其水平与BMI无关,而与性激素、FBG、FINS和HOMA-IR呈不同程度的相关性,提示可能与糖代谢和性激素紊乱有关。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.